Vol. 77, March 2009

Role of MRI in Improving Diagnosis of Breast Tumors

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Role of MRI in Improving Diagnosis of Breast Tumors,KHALED F.Z. HASSAN and INASSE I. GABALLAH

 

Abstract
Aim of Study: To assess the role that can be played by MRI to minimize the number of false positive cases of breast tumors that commonly occur with mammography.
Patients and Methods: This study included 200 consecutive patients aged 40 years or more, who were referred to the Department of Radiology for suspicion of a breast lump. Mammography then magnetic resonance imaging (MRI) was performed for each patient. A patient with a positive finding in any of these two modalities underwent histopathological diagnosis. Sensitivity and specificity were calculated for each imaging modality and that for MRI of mammography positive patients.
Results: Most common benign lesion were fibroadenoma (11%) and radial scars (5.9%), while the most common ma-lignant tumors were invasive ductal carcinoma (37.3%) and ductal carcinoma in situ (21.2%). Prevalence of breast tumors among participants increased with their age. Prevalence of breast tumors among nulliparous participants was significantly higher than that among parous participants (88.6% Vs. 72.5%, respectively, p=0.01). The prevalence of breast tumors was significantly higher among those with positive family history of breast cancer (93.2%) than those with negative family history (70.6%), p=0.003. Mammography provided a higher sensitivity than that provided by MRI (97.5% Vs. 90.7%, respectively), but a lower specificity (48.6% Vs. 94.3%, respectively), which has been fully improved by the application of MRI on cases who were positive by mammography (100%).
Conclusion: The application of MRI for cases with positive mammographic findings can be a cost-effective procedure that greatly limits false positives, increases specificity and spares unnecessary invasive interventions.
Recommendation: To conduct a community-based study to assess the role and cost-effectiveness of MRI in screening for breast cancer among females aged over 40 years, applying MRI on all those with mammographic findings.

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