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The Yield of Pre-operative Breast MRI in Patients According to Breast Tissue Density

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Abstract

Objective

To determine the yield of pre-operative breast MRI according to breast tissue density.

Methods

We performed a retrospective review of 665 consecutive patients who underwent breast MRI in 2012 for pre-operative staging of biopsy-proven breast cancer, 582 of whom had digital mammograms available within 6 months of the MRI were evaluated for breast tissue density and additional lesions seen on breast MRI not identified on mammography. Lesions that could change surgical management if positive were confirmed by percutaneous biopsy.

Results

MRI identified additional lesions changing surgical management in 19 of 61 patients (31%) with fat density, 94/269 (35%) with scattered fibroglandular parenchyma, 89/210 (42%) with heterogeneously dense breasts, and 26/42 (62%) with dense breasts. There was a significant difference between breast density and number of additional findings on MRI (p<0.0001). Patients with dense breasts were 5.1x more likely to have additional findings on MRI in comparison to patients with fat density breasts (95% CI 2.2-12.1, p=0.0001).

Conclusion

Patients with dense breasts are more likely to have additional findings on pre-operative breast MRI in comparison to patients with fat tissue density breasts; if selective use of pre-operative MRI is necessary, patients with dense breast tissue density seem to show the maximal benefit.

Highlights

• Preoperative MRI detects many additional lesions not seen on mammography.

• Increased breast density correlates with more findings on preoperative breast MRI (p<0.0001).

• Extremely dense breasts are more likely to have additional findings on MRI.

• Increased breast density is associated with more MRI findings that changed management.

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Acknowledgments

The scientific guarantor of this publication is Jean Seely. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board.

Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, 501 Smyth Rd, Ottawa, ON, K1H 8L6, Canada

    Jean M. Seely, Leslie Lamb, Neera Malik & Jacqueline Lau

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  1. Jean M. Seely
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  2. Leslie Lamb
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  4. Jacqueline Lau
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Correspondence to Jean M. Seely.

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Seely, J.M., Lamb, L., Malik, N. et al. The Yield of Pre-operative Breast MRI in Patients According to Breast Tissue Density. Eur Radiol 26, 3280–3289 (2016). https://doi.org/10.1007/s00330-015-4118-0

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  • DOI: https://doi.org/10.1007/s00330-015-4118-0

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