False-negative MR imaging of malignant breast tumors

Abstract In this study we analyze MR-negative malignant lesions of the breast. A total of 204 patients with palpable and/or mammographic lesions were studied. The MR technique consisted of the turbo FLASH and MP-RAGE subtraction techniques. All patients underwent surgical biopsy and/or mastectomy and all specimens were examined by the correlative radiologic-histologic mapping technique. A total of 208 lesions were evaluated; 145 turned out to be malignant and 63 proved to be benign. Six malignant lesions were misinterpreted as benign on MR imaging; thus, suspicious contrast enhancement was present in 96 % of the lesions detected by mammography, US, or clinical examination. Especially 4 of the 17 ductal carcinoma in situ (DCIS) lesions were misinterpreted (23.5 %). Despite optimal technique, 6 malignant lesions were not identified by MR imaging. The highest prevalence of these MR occult lesions was in the group of DCIS. Although MR imaging has an important role in the evaluation of breast lesions and, primarily, in ruling out malignancy, one should be aware of the fact that false-negative MR findings do occur.

[1]  O Lucidarme,et al.  Nonpalpable breast tumors: diagnosis with contrast-enhanced subtraction dynamic MR imaging. , 1994, Radiology.

[2]  I. Gribbestad,et al.  Contrast-enhanced magnetic resonance imaging of the breast. , 1992, Acta oncologica.

[3]  P. Lukas,et al.  MRT der Mamma mit 2D-Spinecho- und Gradientenecho-Sequenzen in diagnostischen Problemfällen , 1993 .

[4]  S E Harms,et al.  Three-dimensional gadolinium-enhanced MR imaging of the breast: pulse sequence with fat suppression and magnetization transfer contrast. Work in progress. , 1991, Radiology.

[5]  J. Hendriks,et al.  Histologic multifocality of tis, T1–2 breast carcinomas implications for clinical trials of breast‐conserving surgery , 1985, Cancer.

[6]  N M Hylton,et al.  Imaging techniques for breast MR imaging. , 1994, Magnetic resonance imaging clinics of North America.

[7]  W. Kaiser.  MRM promises earlier breast cancer diagnosis. , 1992, Diagnostic imaging.

[8]  Kaiser Wa.  MRM promises earlier breast cancer diagnosis. , 1992 .

[9]  S. Heywang,et al.  MR imaging of the breast with Gd-DTPA: use and limitations. , 1989, Radiology.

[10]  M. J. van de Vijver,et al.  Ductal carcinoma in situ: a proposal for a new classification. , 1994, Seminars in diagnostic pathology.

[11]  L J van Erning,et al.  MR characterization of suspicious breast lesions with a gadolinium-enhanced TurboFLASH subtraction technique. , 1994, Radiology.

[12]  M D Schnall,et al.  Suspicious breast lesions: MR imaging with radiologic-pathologic correlation. , 1994, Radiology.

[13]  R. Paola,et al.  Correlation Between Contrast Enhancement in Dynamic Magnetic Resonance Imaging of the Breast and Tumor Angiogenesis , 1994, Investigative radiology.

[14]  Anthony J. Guidi,et al.  Microvessel density and distribution in ductal carcinoma in situ of the breast. , 1994, Journal of the National Cancer Institute.

[15]  Heywang-Köbrunner Sh,et al.  Contrast-enhanced magnetic resonance imaging of the breast. , 1994, Investigative radiology.

[16]  L. Baker,et al.  Breast cancer detection demonstration project: Five‐year summary report , 1982, CA: a cancer journal for clinicians.

[17]  Fat-suppressed three-dimensional MR imaging of the breast. , 1993, Radiographics : a review publication of the Radiological Society of North America, Inc.