Browse > Article

Role of MRI in Diagnostic Evaluation of Papillary Lesions of the Breast  

Lee, So-Mi (Department of Radiology, Kyungpook National University Hospital)
Kim, Hye-Jung (Department of Radiology, Kyungpook National University Hospital)
Gwak, Yeon-Joo (Department of Radiology, Kyungpook National University Hospital)
Lee, Hui-Joong (Department of Radiology, Kyungpook National University Hospital)
Jang, Yun-Jin (Department of Radiology, Kyungpook National University Hospital)
Shin, Kyung-Min (Department of Radiology, Kyungpook National University Hospital)
Park, Ji-Young (Department of Pathology, Kyungpook National University Hospital)
Jung, Jin-Hyang (Department of Surgery, Kyungpook National University Hospital)
Publication Information
Investigative Magnetic Resonance Imaging / v.14, no.1, 2010 , pp. 41-46 More about this Journal
Abstract
Purpose : To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast. Materials and methods : Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusionweighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy. Results : At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy. Conclusion : MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.
Keywords
Breast neoplasm; Magnetic resonance (MR); Biopsy;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Hata T, et al. Magnetic resonance imaging for preoperative evaluation of breast cancer: a comparative study with mammography and ultrasonography. J Am Coll Surg 2004;198(2): 190-197   DOI   ScienceOn
2 Woodhams R, et al. ADC mapping of benign and malignant breast tumors. Magn Reson Med Sci 2005;4(1):35-42   DOI   ScienceOn
3 Jacobs TW, JL Connolly, and SJ Schnitt, Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol 2002;26(9):1095-1110   DOI   ScienceOn
4 Sinha S, et al., In vivo diffusion-weighted MRI of the breast: potential for lesion characterization. J Magn Reson Imaging 2002;15(6):693-704   DOI   ScienceOn
5 Puglisi F, et al. Role of mammography, ultrasound and large core biopsy in the diagnostic evaluation of papillary breast lesions. Oncology 2003;65(4):311-315   DOI   ScienceOn
6 Carder PJ, et al. Needle core biopsy can reliably distinguish between benign and malignant papillary lesions of the breast. Histopathology 2005;46(3):320-327   DOI   ScienceOn
7 Fischer U, L Kopka, and E. Grabbe, Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology 1999;213(3);881-888   DOI
8 Tsushima Y, A Takahashi-Taketomi, and K. Endo, Magnetic resonance (MR) differential diagnosis of breast tumors using apparent diffusion coefficient (ADC) on 1.5-T. J Magn Reson Imaging 2009;30(2):249-255   DOI   ScienceOn
9 Hatakenaka, M, et al., Apparent diffusion coefficients of breast tumors: clinical application. Magn Reson Med Sci 2008;7(1): 23-29   DOI   ScienceOn
10 Shin HJ, et al. Papillary lesions of the breast diagnosed at percutaneous sonographically guided biopsy: comparison of sonographic features and biopsy methods. AJR Am J Roentgenol 2008;190(3):630-636   DOI   ScienceOn
11 Lam WW, et al. Role of radiologic features in the management of papillary lesions of the breast. AJR Am J Roentgenol 2006;186(5):1322-1327   DOI   ScienceOn
12 Bode MK, T Rissanen, and M Apaja-Sarkkinen, Ultrasonography- guided core needle biopsy in differential diagnosis of papillary breast tumors. Acta Radiol 2009;50(7):722-729   DOI   ScienceOn
13 Morris EA, Review of breast MRI: indications and limitations. Semin Roentgenol 2001;36(3):226-237   DOI   ScienceOn
14 Daniel BL, et al. Magnetic resonance imaging of intraductal papilloma of the breast. Magn Reson Imaging 2003;21(8):887-892   DOI   ScienceOn
15 Rovno HD, et al. Solitary intraductal papilloma: findings at MR imaging and MR galactography. AJR Am J Roentgenol 1999; 172(1):151-155   DOI
16 Tavassoli FA, Papillary lesions, in Pathology of the breast, F.A. Tavassoli, Editor. 1992, Elsevier: New York. p. 193-227
17 Brookes, MJ and AG Bourke. Radiological appearances of papillary breast lesions. Clin Radiol 2008;63(11):1265-1273   DOI   ScienceOn
18 Rosen PP, Benign papillary tumors, in Rosen's Breast pathology, PP Rosen, Editor. 2001, Lippincott Williams & Wilkins: Baltimore, MD. p. 67-104
19 Radiology, A.C.o., Breast imaging reporting and data system. 3 ed. Magnetic resonance imaging. 2003, Reston, VA: American College of Radiology
20 Liberman L, Clinical management issues in percutaneous core breast biopsy. Radiol Clin North Am 2000;38(4):791-807   DOI   ScienceOn
21 Liberman L, et al. Percutaneous large-core biopsy of papillary breast lesions. AJR Am J Roentgenol 1999;172(2): 331-337   DOI
22 Rosen EL, et al. Imaging-guided core needle biopsy of papillary lesions of the breast. AJR Am J Roentgenol 2002; 179(5):1185- 1192   DOI
23 Gendler LS, et al. Association of breast cancer with papillary lesions identified at percutaneous image-guided breast biopsy. Am J Surg 2004;188(4):365-370   DOI   ScienceOn
24 5.Ivan D, et al. Accuracy of core needle biopsy diagnosis in assessing papillary breast lesions: histologic predictors of malignancy. Mod Pathol 2004;17(2):165-171   DOI   ScienceOn
25 Agoff SN and TJ Lawton, Papillary lesions of the breast with and without atypical ductal hyperplasia: can we accurately predict benign behavior from core needle biopsy? Am J Clin Pathol 2004;122(3):440-443   DOI   ScienceOn