Sonomammography versus MRI in Evaluation of BI-RADS III Breast Lesion

Abstract

Background: Breast cancer is sometimes found after symptoms appear, but many women with breast cancer have no symptoms. This is why regular breast cancer screening is so important, early detection and treatment are the most important strategies to prevent deaths from breast cancer. Breast cancer that's found early, when it's small and has not spread, is easier to treat successfully, regular screening tests are the most reliable way for early detection. Objective: to high light the role of sonomammography versus Magnetic Resonance Imaging (MRI) in evaluation of BI-RADS III (Breast Imaging Reporting and Data System) breast lesion. Patients and Methods: in this retrospective study, 28 patients with BI-RADS III breast lesion were assessed by Digital mammography (DM), Ultrasound (US) and MRI. The resultant images were correlated with reports of the pathology specimens. Results: histopathological analysis was done for each lesion with 13 lesions (46.43%) proved to be benign, 15 lesions (53.57%) proved to be malignant. The sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) of mammography (MG), ultrasonography and MRI in BI-RADS III breast lesions were calculated. Conclusion: BI-RADS III lesions group is a very critical group to deal with as it exhibits characters of both malignant and benign lesions. According to our study Dynamic contrast enhanced-Magnetic Resonance Imaging. (DCE-MRI) should go hand by hand with sonomammogaphy especially in BI-RADS III patients group, patients with benign looking lesion six months follow up is recommended and those with malignant looking lesion biopsy should be done.

Can DWI-MRI be an alternative to DCE-MRI in the diagnosis of troublesome breast lesions?

“…A respective sonomammographic sensitivity and specificity of 73% and 80% were achieved in our study which is much higher than the overall reported sensitivity of 30-60 and 40-80 stated by Mehnati et al [5]. However, it is comparative with Eisa et al who reported a sensitivity of 68 and specificity of 74% [19].…”

MR diffusion-weighted imaging precision in BIRADS downstaging

“…That was superior to the sensitivity and specificity reported by Mehnati et al in [8], which were 30-60 and 40-80, respectively. Nevertheless, the results in the current study were in reproachment to the findings recorded by Eisa et al in [9] and Hashem et al [7] in their studies, who demonstrated a specificity of 74% and 80%, with sensitivity of 68% and 73%, respectively. These paralogisms in the mammography are mainly attributed to the dense breast cases (ACR III and IV), where the fibro glandular tissue almost conceal any breast lesions, yet aided by ultrasound; their sensitivity and specificity to detect and characterize lesions are relatively higher.…”