Role of magnetic resonance imaging in the evaluation of non-palpable breast masses

Abstract

Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provides anatomical and functional information with high sensitivity and variable specificity, making it a useful tool in the detection of breast cancer. The noninvasive functional imaging method known as diffusion-weighted imaging (DWI), sensitive to tissue microstructure and cellularity. The aim of this work was to assess the role of DCE-MRI and DWI in the evaluation of non-palpable breast masses. Methods: Fifty female cases participated in a prospective research who were suspected to have non-palpable breast masses accidentally discovered or suspected by ultrasound and referred to MR units. All cases were subjected to complete personal and medical history, full clinical examination, laboratory investigations, mammogram and breast ultrasound and breast MRI. Results: DCE-MRI could predict non-palpable malignant lumps with 89.66% sensitivity, 95.24% specificity, 96.30% (PPV), 86.96% (NPV) and 92% accuracy. MRI could predict non-palpable benign lumps with 90.48% sensitivity, 96.55% specificity, 95% (PPV), 93.33% (NPV) and 94% accuracy. DWI could predict malignant masses with 93.10% sensitivity, 71.43% specificity, 81.82% (PPV), 88.24% (NPV) and accuracy 84%.Conclusions: DCE-MRI outperformed DWI-MRI in diagnostic performance; however, DWI-MRI still demonstrated good diagnostic performance with a 93.1% sensitivity and specificity of 71.4%. Both are excellent non-invasive techniques that are very useful in assessing non-palpable breast masses.