TITLE:
Efficacy of Magnetic Resonance Imaging in BIRADS 3, 4 and 5 Patients Detected on Full Field Digital Mammography: Our Experience
AUTHORS:
Atul Patil, Samadhan Pawar, Raj Nagarkar, Bhargav Gaikwad
KEYWORDS:
Breast Cancer, Screening, Mammography, Magnetic Resonance Imaging
JOURNAL NAME:
Open Journal of Clinical Diagnostics,
Vol.9 No.1,
March
25,
2019
ABSTRACT: Aim of the
study: To perform Dynamic contrast enhanced MRI of breast
in patients with positive findings (BIRADS 3, 4 and 5) detected on screening
mammography; to correlate the findings of digital mammography and contrast
enhanced MRI of breast with histopathological examinations. Settings and Design: A prospective observation study was conducted at a single centre, i.e. HCG Manavata Cancer Centre. Materials
and Methods: Screening mammography was performed on patients with age >
40 years and on patients with age 35 - 40 years having positive family history.
The positive mammography was reported and the lesions classified according to
BIRADS criteria for mammography. Results: Mammographic examination of
the breast lesions yielded an overall sensitivity of 97.67% and a specificity
of 85.71%. In our study we combined both morphologic and dynamic parameters and
its modification into BIRADS category for lesion classification. The
sensitivity of MRI examinations was 97.67% while the specificity was 71.43%.
Spiculated margins were encountered only in malignant lesions (p = 0.0006). Statistical correlation was
obtained between the pathologically proven benign and malignant lesions regarding
their enhancement pattern with p value of Conclusion: As per the results, dynamic contrast MRI
had high sensitivity but limited specificity. We did not find any significant
difference between FFDM and MRI in terms of diagnostic accuracy. The use of DWI
showed high specificity at cut off point of ADC value—0.85 mm2/s. Thus,
DWI can be used in addition of morphological and dynamic kinetic
characteristics to increase specificity of MRI.