Frequency and Outcomes of Incidental Breast Lesions Detected on Abdominal MRI Over a 7-Year Period

Prabhu, Vinay; Chhor, Chloe; Ego-Osuala, Islamiat O.; Xiao, Jennifer; Hindman, Nicole; Rosenkrantz, Andrew B.

doi:10.2214/ajr.16.16683

Cited by 9 publications

(7 citation statements)

References 13 publications

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“…In this study, we evaluated the incidence and outcomes of incidental breast lesions that were detected on nonbreast cross‐sectional imaging studies. We found that the incidence and rate of malignancy of incidental breast lesions in our study cohort were overall similar to those reported in previously published studies . However, to our knowledge, there are no previous studies comparing the incidence and outcomes of incidental breast lesions detected on different cross‐sectional imaging studies.…”

Section: Discussionsupporting

confidence: 89%

“…We found that the incidence and rate of malignancy of incidental breast lesions in our study cohort were overall similar to those reported in previously published studies. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] However, to our knowledge, there are no previous studies comparing the incidence Another factor that was found to be significantly associated with increased rate of malignancy was patient age, as incidental breast lesions in older patients were significantly more likely to be malignant, which is consistent with the known increase in the risk of breast cancer with age. 17 We found that only 41% of the patients with incidentally Our study has several limitations, one of which is the single-site retrospective design of the study.…”

Section: Discussionsupporting

confidence: 63%

“…Previous studies have looked at the incidence and outcomes of incidental breast lesions detected on CT examinations, those found on MRI examinations, and those seen on PET examinations . However, to our knowledge, there are no known published studies evaluating the outcomes of incidental breast lesions detected across different cross‐sectional imaging modalities.…”

Section: Introductionmentioning

confidence: 99%

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Incidence and outcomes of incidental breast lesions detected on cross-sectional imaging examinations

et al. 2018

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The aim of this study was to determine the frequency and outcomes of incidental breast lesions detected on nonbreast specific cross-sectional imaging examinations. A retrospective review of the medical records was performed to identify all patients without a known history of breast cancer, who had an incidentally discovered breast lesion detected on a nonbreast imaging examination performed at our institution between September 2008 and August 2012 for this IRB-approved, HIPAA compliant study. Outcomes of the incidental lesions were determined by follow-up with dedicated breast imaging (mammography, breast ultrasound, and/or breast MRI) or results of biopsy, if performed. Imaging modality of detection, imaging features, patient age, patient location at the time of the nonbreast imaging examination, type of follow-up, and final outcome were recorded. Rates of malignancy were also calculated, and comparison was made across the different cross-sectional imaging modalities. Kruskal-Wallis and Fisher's exact tests were used to identify factors associated with an increased rate of malignancy. Logistic regression was used to model the risk of malignancy as a function of continuous predictors (such as patient age or lesion size); odds ratios and 95% confidence intervals were obtained. A total of 292 patients with incidental breast lesions were identified, 242 of whom had incidental lesions were noted on computed tomography (CT) studies, 25 on magnetic resonance imaging (MRI), and 25 on positron emission tomography (PET). Although most of the incidental breast lesions were detected on CT examinations, PET studies had the highest rate of detection of incidental breast lesions per number of studies performed (rate of incidental breast lesion detection on PET studies was 0.29%, compared to 0.10% for CT and 0.01% for MRI). Of the 121 of 292 (41%) patients who received dedicated breast imaging work-up at our institution, 40 of 121 (33%) underwent biopsy and 25 of 121 (21%) had malignancy. There was a significantly increased rate of malignancy in older patients (odds ratio: 1.05, 95% CI: 1.02-1.093; P = .006). Additionally, patients with PET-detected incidental breast lesions had a significantly higher rate of malignancy (55%), compared to patients with CT-detected (35%) and MRI-detected (8%) incidental breast lesions (P = .038). The rate of malignancy upon follow-up of incidental breast lesions detected on nonbreast imaging examinations in this retrospective study was 21%, supporting the importance of emphasizing further work-up of all incidentally detected breast lesions with dedicated breast imaging. Additionally, we found that PET examinations had the highest rate of detection of incidental breast lesions and the highest rate of malignancy, which suggests that PET examinations may be more specific for predicting the likelihood of malignancy of incidental breast lesions, compared to CT and MRI.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

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Incidence and outcomes of incidental breast lesions detected on cross-sectional imaging examinations

et al. 2018

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“…The challenge of managing incidental findings (IFs) in clinical practice and research is growing with the increasing accessibility of powerful imaging modalities such as MRI [ 1 – 3 ]. IFs frequently occur in clinical as well as in research settings [ 1 , 2 , 4 ]. The use of whole-body MRI (wb-MRI) in a population-based cohort of 2500 participants resulted in 13,455 IFs, of which 1330 were potentially clinically relevant and disclosed to participants [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

The effects of incidental findings from whole-body MRI on the frequency of biopsies and detected malignancies or benign conditions in a general population cohort study

et al. 2020

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Magnetic resonance imaging (MRI) yields numerous tumor-related incidental findings (IFs) which may trigger diagnostics such as biopsies. To clarify these effects, we studied how whole-body MRI IF disclosure in a population-based cohort affected biopsy frequency and the detection of malignancies. Laboratory disclosures were also assessed. Data from 6753 participants in the Study of Health in Pomerania (SHIP) examined between 2008 and 2012 were utilized. All underwent laboratory examinations and 3371 (49.9%) a whole-body MRI. Electronic biopsy reports from 2002 to 2017 were linked to participants and assigned to outcome categories. Biopsy frequency 2 years pre- and post-SHIP was investigated using generalized estimating equations with a negative-binomial distribution. Overall 8208 IFs (laboratory findings outside reference limits: 6839; MRI: 1369) were disclosed to 4707 participants; 2271 biopsy reports belonged to 1200 participants (17.8%). Of these, 938 biopsies occurred pre-SHIP; 1333 post-SHIP (event rate/100 observation years = 6.9 [95% CI 6.5; 7.4]; 9.9 [9.3; 10.4]). Age, cancer history, recent hospitalization, female sex, and IF disclosure were associated with higher biopsy rates. Nonmalignant biopsy results increased more in participants with disclosures (post-/pre-SHIP rate ratio 1.39 [95% CI 1.22; 1.58]) than without (1.09 [95% CI 0.85; 1.38]). Malignant biopsy results were more frequent post-SHIP (rate ratio 1.74 [95% CI 1.27; 2.42]). Biopsies increased after participation in a population-based cohort study with MRI and laboratory IF disclosure. Most biopsies resulted in no findings and few malignancies were diagnosed, indicating potential overtesting and overdiagnosis. A more restrictive policy regarding IF disclosure from research findings is required.

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“…4 However, data on breast incidental findings on abdominal and chest MRI (MRI-AC) are limited with significant heterogeneity in prior results. [5][6][7] Our goal was to evaluate the frequency of breast incidental findings on MRI-AC, document radiologist recommendations for follow-up diagnostic breast imaging, assess the rate of compliance with follow-up, and identify factors associated with improved follow-up.…”

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confidence: 99%

Breast incidental findings on abdominal and chest MRI

et al. 2020

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Frequency and Outcomes of Incidental Breast Lesions Detected on Abdominal MRI Over a 7-Year Period

Cited by 9 publications

References 13 publications

Incidence and outcomes of incidental breast lesions detected on cross-sectional imaging examinations

Incidence and outcomes of incidental breast lesions detected on cross-sectional imaging examinations

The effects of incidental findings from whole-body MRI on the frequency of biopsies and detected malignancies or benign conditions in a general population cohort study

Breast incidental findings on abdominal and chest MRI

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