Abstract
Purpose
This study sought to determine the prevalence of extramammary findings on magnetic resonance (MR) imaging of the breast.
Materials and methods
We retrospectively reviewed the data sets of 828 consecutive patients (F/M; 821/7; mean age, 50±11 years) who underwent breast MR imaging. The most common clinical indication was assessment of lesion extent in patients with known breast tumour (n=380, 46%), characterisation of equivocal findings at conventional imaging (n=331, 40%), evaluation of women at high risk for breast cancer (n=43, 5%) and following breast augmentation therapy (n=74, 9%).
Results
Collateral findings were found in 282/828 (34%) patients. In those 282 patients, 480 incidental lesions were detected. The most common localisation was the liver (231/480; 48%). Of the 480 collateral findings, 66 (14% in 38 patients) were classified as significant and deserving further investigation. These comprised 26 metastatic bony lesions, 15 mediastinal/axillary lymph nodes, six metastatic lung lesions, five metastatic liver lesions, four pneumonitis, two aneurysms of the ascending aorta, two adrenal adenomas, one neurofibroma of the back, one multiple myeloma, one mediastinal lymphoma, one sternal amyloidosis, one left ventricular dilatation and one trapezium lipoma.
Conclusions
There is a high prevalence of extramammary findings on breast MR imaging. Evaluation of the examination should focus not only on the breast fields but also consider extramammary findings to avoid inappropriate management and possible legal issues.
Riassunto
Obiettivo
Scopo di questo lavoro è determinare la prevalenza di reperti extra-mammari alla RM della mammella.
Materiali e metodi
Sono stati analizzati 828 pazienti (F/M 821/7, età media 50±11 anni), sottoposti a esame RM della mammella. Le indicazione cliniche all’esame RM, sono state la valutazione dell’estensione di malattia in pazienti con neoplasia mammaria nota (380, 46%), la caratterizzazione di lesioni indeterminate all’imaging convenzionale (331, 40%), lo studio di pazienti ad alto rischio per eteroplasia mammaria (43, 5%) e di pazienti sottoposte a mastoplastica additiva (74, 9%).
Risultati
Sono stati riscontrati reperti collaterali in 282/828 (34%) pazienti. Nelle 282 pazienti con reperti collaterali, è stato riscontrato un totale di 480 lesioni incidentali. La più comune localizzazione è stata il fegato con 231/480 casi (48%). Dei 480 reperti collaterali, 66 (14% in 38 pazienti) sono stati considerati significativi e meritevoli di ulteriore approfondimento diagnostico. Di questi, 26 risultavano lesioni ossee metastatiche, 15 linfonodi mediastinici e/o ascellari, 6 metastasi polmonari, 5 metastasi epatiche, 4 polmoniti, 2 aneurismi dell’aorta ascendente, 2 adenomi surrenalici, 1 neurofibroma del dorso, 1 mieloma multiplo, 1 linfoma mediastinico, 1 amiloidosi sternale, 1 cardiomiopatia dilatativa, 1 lipoma del trapezio.
Conclusioni
La prevalenza di reperti extra-mammari è alta nelle pazienti sottoposte a RM della mammella. Nell’interpretazione di un esame RM della mammella, risulta indispensabile anche la valutazione delle strutture extra-ghiandolari, per evitare terapie inadeguate e possibili problematiche medico-legali.
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Iodice, D., Di Donato, O., Liccardo, I. et al. Prevalence of extramammary findings on breast MRI: a large retrospective single-centre study. Radiol med 118, 1109–1118 (2013). https://doi.org/10.1007/s11547-013-0937-8
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DOI: https://doi.org/10.1007/s11547-013-0937-8