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Open Access 30-08-2023 | Breast MRI | Breast

Breast density and the likelihood of malignant MRI-detected lesions in women diagnosed with breast cancer

Authors: Antti Sassi, Annukka Salminen, Arja Jukkola, Maija Tervo, Niina Mäenpää, Saara Turtiainen, Leena Tiainen, Timo Liimatainen, Teemu Tolonen, Heini Huhtala, Irina Rinta-Kiikka, Otso Arponen

Published in: European Radiology | Issue 11/2023

Abstract

Objectives

To assess whether mammographic breast density in women diagnosed with breast cancer correlates with the total number of incidental magnetic resonance imaging (MRI)-detected lesions and the likelihood of the lesions being malignant.

Methods

Patients diagnosed with breast cancer meeting the EUSOBI and EUSOMA criteria for preoperative breast MRI routinely undergo mammography and ultrasound before MRI at our institution. Incidental suspicious breast lesions detected in MRI are biopsied. We included patients diagnosed with invasive breast cancers between 2014 and 2019 who underwent preoperative breast MRI. One reader retrospectively determined breast density categories according to the 5^th edition of the BI-RADS lexicon.

Results

Of 946 patients with 973 malignant primary breast tumors, 166 (17.5%) had a total of 175 (18.0%) incidental MRI-detected lesions (82 (46.9%) malignant and 93 (53.1%) benign). High breast density according to BI-RADS was associated with higher incidence of all incidental enhancing lesions in preoperative breast MRIs: 2.66 (95% confidence interval: 1.03–6.86) higher for BI-RADS density category B, 2.68 (1.04–6.92) for category C, and 3.67 (1.36–9.93) for category D compared to category A (p < 0.05). However, high breast density did not predict higher incidence of malignant incidental lesions (p = 0.741). Incidental MRI-detected lesions in the contralateral breast were more likely benign (p < 0.001): 18 (27.3%)/48 (72.7%) vs. 64 (58.7%)/45 (41.3%) malignant/benign incidental lesions in contralateral vs. ipsilateral breasts.

Conclusion

Women diagnosed with breast cancer who have dense breasts have more incidental MRI-detected lesions, but higher breast density does not translate to increased likelihood of malignant incidental lesions.

Clinical relevance statement

Dense breasts should not be considered as an indication for preoperative breast MRI in women diagnosed with breast cancer.

Key Points

• The role of preoperative MRI of patients with dense breasts diagnosed with breast cancer is under debate.

• Women with denser breasts have a higher incidence of all MRI-detected incidental breast lesions, but the incidence of malignant MRI-detected incidental lesions is not higher than in women with fatty breasts.

• High breast density alone should not indicate preoperative breast MRI.

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Title: Breast density and the likelihood of malignant MRI-detected lesions in women diagnosed with breast cancer
Authors: Antti Sassi
Annukka Salminen
Arja Jukkola
Maija Tervo
Niina Mäenpää
Saara Turtiainen
Leena Tiainen
Timo Liimatainen
Teemu Tolonen
Heini Huhtala
Irina Rinta-Kiikka
Otso Arponen
Publication date: 30-08-2023
Publisher: Springer Berlin Heidelberg
Keywords: Breast MRI
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Breast Cancer
Breast Cancer
Mammography
Mammography
Ultrasound
Ultrasound
Published in: European Radiology / Issue 11/2023
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10072-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Breast density and the likelihood of malignant MRI-detected lesions in women diagnosed with breast cancer

Abstract

Objectives

Methods

Results

Conclusion

Clinical relevance statement

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Clinical relevance statement

Key Points

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