MRI-Detected Breast Lesions That Change Should Be Investigated

Clinicians should view screening MRI-detected breast lesions that change with suspicion and do further testing.

Breast lesions detected by screening MRI that change should be viewed with a high degree of suspicion, according to a study published in the American Journal of Roentgenology.

Researchers from the University of Chicago sought to evaluate the nature of early breast cancer MRI features among cancers detected during MIR screening. The study took place from 2003 to 2012.

Sixteen incident breast cancers in 15 patients were detected by screening MRI. Nine were retrospectively identifiable on prior MRIs when they were false-negatives.

The researchers found there were 11 mass lesions (69 percent) among the 16 incident cancers, three foci (19 percent) and two nonmass-like enhancement lesions (13 percent). Among the nine false-negatives, there were five foci, two masses, and two nonmass-like enhancement lesions. All nine showed growth in the most recent MRI, with a median 80 percent increase.

“Four lesions showed rapid uptake kinetics on prior examinations, and five lesions showed a change in kinetic pattern from slow to rapid uptake,” the authors wrote.

Evaluating the five foci, the researchers found one was isolated, and four were in the background of other foci.

The researchers concluded “any lesion that increases in size, has rapid uptake kinetics or a change in kinetic pattern, or is an isolated focus or focus showing more enhancement than other foci should be viewed with a high degree of suspicion, and a biopsy should be considered.”


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