Single focus on breast magnetic resonance imaging: diagnosis based on kinetic pattern and patient age. (June 2017)

• Record Type: Journal Article
• Authors: Machida, Youichi; Shimauchi, Akiko; Kuroki, Yoshifumi; Tozaki, Mitsuhiro; Kato, Yoshiaki; Hoshi, Kazuei; Fukuma, Eisuke
• Is Part Of: Acta radiologica. Volume 58:Number 6(2017:Jun.)
• Page Start: 652
• Page End: 659
• Publication Date: 2017-06
• Subjects: Breast -- magnetic resonance imaging (MRI) -- contrast media -- diagnosis -- breast neoplasms; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185116668212
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Because of its small size, a focus in breast magnetic resonance imaging (MRI) must be evaluated on the basis of characteristics other than morphologic features. Patient-related factors including patient age, in conjunction with lesion-related factors, could be useful for decision-making. Purpose: To assess the probability of malignant foci based on both lesion- and patient-related factors, and to propose a relevant decision-making method. Material and Methods: Foci in our breast MRI database dating from April 2006 to June 2013 were retrospectively identified and analyzed. A Fisher's exact test or a Mann–Whitney U test were performed for univariate analyses, and factors that showed a significant association with outcome in the univariate analyses were subjected to multivariate analysis using a logistic regression model. A decision tree was then drawn using the significant predictors confirmed by multivariate analysis. Results: In total, 184 foci (168 benign, 16 malignant) in 184 patients were analyzed in our study. The presence of a washout pattern and older age were found to be significant predictors of malignancy ( P < 0.0001; odds ratio [OR], 17.8; P = 0.021; OR, 1.1, respectively). The main decisive node on the decision tree was the presence of a washout pattern, followed by whether the patient's age was >63 years. Conclusion: An enhancing focus showing a washout pattern, especially in older patients, may warrant immediate biopsy rather than short-interval follow-up.