Magnetic resonance imaging of the breast: Could it be used as a screening test?

Abstract

Objectives: To investigate whether magnetic resonance imaging (MRI) best detects early malignancy in high-risk women.

Methods: A retrospective, cross-sectional study, carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, included 419 female breast cancer patients aged 16-84 years (mean age of 49). Data were collected from the radiological department's database to compare the MRI, ultrasound (US), and mammography results, with or without tissue biopsy.

Results: In diagnosing benign versus malignant lesions, MRI showed significant agreement with tissue biopsy, with high sensitivity (70%) and specificity (87%); its positive predictive value (PPV) was 92% and negative predictive value (NPV) was 56%. While US has a PPV of 84% and NPV of 63%; with a sensitivity (79%) and specificity (71%). In patients without tissue biopsy, there was little difference between mammography and US compared with MRI results.

Conclusion: Magnetic resonance imaging is more effective than US and mammography for early detection of BC. It showed high sensitivity in detecting breast lesions and high specificity in characterizing their nature when correlated with pathological results. Ultrasound screening followed by MRI is suggested for undetected or suspected lesions. This will increase the breast lesion detection rate, reduce unneeded tissue biopsies, and enhance the disease's survival rate.