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Breast Cancer
Published in: Breast Cancer 1/2017

01-01-2017 | Original Article

A pilot study to determine the diagnostic criteria of spiculated masses for BI-RADS MRI category 5: when to perform re-biopsy after discordant pathologic result?

Authors: Natsuko Onishi, Masako Kataoka, Shotaro Kanao, Makiko Kawai, Mami Iima, Akane Ohashi, Masakazu Toi, Kaori Togashi

Published in: Breast Cancer | Issue 1/2017

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Abstract

Background

This study aimed to investigate (1) the MRI and clinical findings useful to differentiate malignant from benign spiculated masses and (2) the diagnostic criteria of spiculated masses for BI-RADS MRI category 5, for which any non-malignant biopsy result is considered discordant and a re-biopsy is recommended.

Materials and methods

Spiculated breast masses, depicted by 3.0/1.5-T contrast-enhanced MRI between June 2008 and March 2014, were retrospectively analyzed. Patient’s age, lesion size, minimum/average apparent diffusion coefficient values (ADCmin/ADCave), and BI-RADS descriptors were compared between malignant and benign lesions. Based on these results, we assessed criteria to define category 5 spiculated masses with a ≥95 % probability of malignancy and evaluated their diagnostic performance.

Results

A total of 140 lesions (Malignant group, n = 131; Benign group, n = 9) were analyzed. Patient’s age, lesion size, ADCmin and ADCave showed significant differences between the two groups, while none of the BI-RADS descriptors, including kinetic curve assessment, showed any significant difference in frequency. Multivariate logistic regression analysis demonstrated that patient’s age and lesion size were the significant predictive factors of malignancy. Of all the assessed criteria for category 5 spiculated masses, “age >50 years or size >9 mm, or both” were selected as the best criteria to minimize the possibility of unnecessary re-biopsies and inappropriate follow-up for malignancies.

Conclusions

Patient’s age and lesion size are useful to differentiate malignant from benign spiculated breast masses. In cases with non-malignant biopsy results, spiculated masses with “age >50 years or size >9 mm, or both” are more likely malignant.
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Metadata
Title
A pilot study to determine the diagnostic criteria of spiculated masses for BI-RADS MRI category 5: when to perform re-biopsy after discordant pathologic result?
Authors
Natsuko Onishi
Masako Kataoka
Shotaro Kanao
Makiko Kawai
Mami Iima
Akane Ohashi
Masakazu Toi
Kaori Togashi
Publication date
01-01-2017
Publisher
Springer Japan
Published in
Breast Cancer / Issue 1/2017
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-016-0668-5

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