Skip to main content

Advertisement

Log in

Extra-mammary findings in breast MRI

  • Breast
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

Incidental extra-mammary findings in breast Magnetic Resonance Imaging (MRI) may be benign in nature, but may also represent a metastasis or another important lesion. We aimed to analyse the prevalence and clinical relevance of these unexpected findings.

Methods

A retrospective review of 1535 breast MRIs was conducted. Only axial sequences were reassessed. Confirmation examinations were obtained in all cases.

Results

285 patients had a confirmed incidental finding, which were located in the liver (51.9%), lung (11.2%), bone (7%), mediastinal lymph nodes (4.2%) or consisted of pleural/pericardial effusion (15.4%). 20.4% of incidental findings were confirmed to be malignant. Positive predictive value for MRI to detect a metastatic lesion was high if located within the bone (89%), lymph nodes (83%) and lung (59%), while it was low if located within the liver (9%) or if it consisted of pleural/pericardial effusion (6%). The axial enhanced sequence showed superior sensitivity to unenhanced images in detecting metastatic lesions, especially if only smaller (≤10 mm.) lesions were considered.

Conclusions

The prevalence of metastatic incidental extra-mammary findings is not negligible. Particular attention should be to incidental findings located within the lung, bone and mediastinal lymph nodes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Schnall MD, Blume J, Bluemke DA et al (2006) Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 238:42–53

    Article  PubMed  Google Scholar 

  2. Warren RM, Pointon L, Thompson D et al (2005) UK Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group Reading protocol for dynamic contrast-enhanced MR images of the breast: sensitivity and specificity analysis. Radiology 236:779–788

    Article  PubMed  Google Scholar 

  3. Yabuuchi H, Kuroiwa T, Kusumoto C, Fukuya T, Ohno S, Hachitanda Y (2006) Incidentally detected lesions on contrast-enhanced MR imaging in candidates for breast conserving therapy: correlation between MR findings and histological diagnosis. J Magn Reson Imaging 23:486–492

    Article  PubMed  Google Scholar 

  4. Yabuuchi H, Matsuo Y, Okafuji T et al (2008) Enhanced mass on contrast-enhanced breast MR imaging: lesion characterization using combination of dynamic contrast-enhanced and diffusion-weighted MR images. J Magn Reson Imaging 28:1157–1165

    Article  PubMed  Google Scholar 

  5. Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316

    Article  PubMed  Google Scholar 

  6. Rausch R (2008) Spectrum of extra-mammary findings on breast MRI: a pictorial review. Breast J 14:591–600

    Article  Google Scholar 

  7. Morakkabati-Spitz N, Sondermann E, Schmiedel A et al (2003) Prevalence and type of incidental extramammary findings in MRI of the breast. Rofo 175:199–202

    PubMed  CAS  Google Scholar 

  8. Hill KA, Rosen B, Shaw P, Causer PA, Warner E (2007) Incidental MRI detection of BRCA1-related solitary peritoneal carcinoma during breast screening—A case report. Gynecol Oncol 107:136–9

    Article  PubMed  CAS  Google Scholar 

  9. Watts KA, Watts JR Jr (2007) Incidental discovery of an anterior mediastinal angiomyolipoma. J Thorac Imaging 22:180–1

    Article  PubMed  Google Scholar 

  10. Beatty JS, Williams HT, Aldridge BA et al (2009) Incidental PET/CT findings in the cancer patient: how should they be managed? Surgery 146:274–281

    Article  PubMed  Google Scholar 

  11. Cardoso F, Castiglione M (2009) Locally recurrent and metastatic breast cancer: ESMO clinical Recommendations for diagnosis, treatment and follow-up. Ann Oncol Suppl 20:15–18

    Google Scholar 

  12. Gavenonis SC, Roth SO (2010) Role of magnetic resonance imaging in evaluating the extent of disease. Magn Reson Imaging Clin N Am 18:199–206

    Article  PubMed  Google Scholar 

  13. Olivas-Maguregui S, Villaseñor-Navarro Y, Ferrari-Carballo T et al (2008) Importance of the preoperative evaluation of multifocal and multicentric breast cancer with magnetic resonance imaging in women with dense parenchyma. Rev Invest Clin 60:382–389

    PubMed  Google Scholar 

  14. Patani N, Mokbel K (2008) The utility of MRI for the screening and staging of breast cancer. Int J Clin Pract 62:450–453

    Article  PubMed  CAS  Google Scholar 

  15. Kuhl C, Kuhn W, Braun M, Schild H (2007) Pre-operative staging of breast cancer with breast MRI: one step forward, two steps back? Breast Suppl 16:S34–44

    Article  Google Scholar 

  16. Brennan ME, Houssami N, Lord S et al (2009) Magnetic resonance imaging screening of the contralateral breast in women with newly diagnosed breast cancer: systematic review and meta-analysis of incremental cancer detection and impact on surgical management. J Clin Oncol 27:5640–5649

    Article  PubMed  Google Scholar 

  17. Al-Hallaq HA, Mell LK, Bradley JA et al (2008) Magnetic resonance imaging identifies multifocal and multicentric disease in breast cancer patients who are eligible for partial breast irradiation. Cancer 113:2408–2414

    Article  PubMed  Google Scholar 

  18. vanSonnenberg E, Wroblicka JT, D’Agostino HB et al (1994) Symptomatic hepatic cysts: percutaneous drainage and sclerosis. Radiology 190:387–392

    PubMed  CAS  Google Scholar 

  19. Khalil HI, Patterson SA, Panicek DM (2005) Hepatic lesions deemed too small to characterize at CT: prevalence and importance in women with breast cancer. Radiology 235:872–878

    Article  PubMed  Google Scholar 

  20. Schwartz LH, Gandras EJ, Colangelo SM, Ercolani MC, Panicek DM (1999) Prevalence and importance of small hepatic lesions found at CT in patients with cancer. Radiology 210:71–74

    PubMed  CAS  Google Scholar 

  21. Blakeborough A, Ward J, Wilson D et al (1997) Hepatic lesion detection at MR imaging: a comparative study with four sequences. Radiology 203:759–765

    PubMed  CAS  Google Scholar 

  22. Yamashita Y, Hatanaka Y, Yamamoto H et al (1994) Differential diagnosis of focal liver lesions: role of spin-echo and contrast-enhanced dynamic MR imaging. Radiology 193:59–65

    PubMed  CAS  Google Scholar 

  23. Hamm B, Thoeni RF, Gould RG et al (1994) Focal liver lesions: characterization with nonenhanced and dynamic contrast material-enhanced MR imaging. Radiology 190:417–423

    PubMed  CAS  Google Scholar 

  24. Roberts CC, Daffner RH, Weissman BN et al (2010) ACR appropriateness criteria on metastatic bone disease. J Am Coll Radiol 7:400–409

    Article  PubMed  Google Scholar 

  25. Jeong YJ, Kim S, Kwak SW et al (2008) Neoplastic and nonneoplastic conditions of serosal membrane origin: CT findings. Radiographics 28:801–817

    Article  PubMed  Google Scholar 

  26. Heelan RT (1994) CT and MR imaging in the evaluation of pleural masses. Chest Surg Clin N Am 4:431–450

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pierluigi Rinaldi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rinaldi, P., Costantini, M., Belli, P. et al. Extra-mammary findings in breast MRI. Eur Radiol 21, 2268–2276 (2011). https://doi.org/10.1007/s00330-011-2183-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-011-2183-6

Keywords

Navigation