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Relationship between body mass index and malignancy rates of MRI-guided breast biopsies: impact of clinicodemographic factors

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

To determine the positive predictive value (PPV) of magnetic resonance imaging (MRI)-guided breast biopsy stratified by body mass index (BMI). Secondary endpoints include evaluation of indications for breast MRI and identification of factors associated with malignant biopsy.

Methods

We retrospectively analyzed results of MRI-guided breast biopsies in a consecutive cohort of women at a single institution between 2014 and 2019. The PPV was compared between BMI subgroups and the overall group by the one-sample z-test. Factors associated with malignant biopsy were analyzed using multivariate regression analysis.

Results

Among 427 MRI-guided breast biopsies, the PPV was significantly higher in patients with a BMI ≥ 35 compared to BMI < 35 (38.6% versus 24.5%, p = 0.043). This remained true in the 180 biopsies from high-risk screening studies, but there was no difference in PPV by BMI in the 205 biopsies performed to evaluate extent of known disease. Among this cohort who underwent MRI-guided breast biopsy, the underlying indication for MRI was less likely to be high-risk screening in those with a higher BMI or Black or Hispanic race (p = 0.015 and p < 0.001, respectively). For high-risk screening studies, only BMI ≥ 35 was associated with malignant biopsies (OR 37.5, p = 0.003). For evaluation of extent of disease studies, only increased lesion size was a significant predictor of malignant result (OR 1.01, p = 0.04).

Conclusions

Among women who underwent MRI-guided breast biopsy, elevated BMI was associated with increased PPV and malignant biopsies. Patients with a higher BMI or Black or Hispanic race who had MRI-guided biopsy were less likely to be undergoing high-risk screening and more likely to have breast MRI to evaluate extent of known disease.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to patient privacy laws but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank Pamela Derish in the UCSF Department of Surgery for assistance in editing this manuscript.

Funding

No funding was provided for this study.

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Authors and Affiliations

  1. Department of Surgery, University of California, San Francisco, 1825 4th Street, 3rd Floor, Box 1710, San Francisco, CA, 94158, USA

    Annie Tang, Caitlin M. Cohan, Keith S. Hansen, Genna Beattie & Rita A. Mukhtar

  2. Department of Radiology, University of California San Francisco, San Francisco, CA, USA

    Heather I. Greenwood

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  1. Annie Tang
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  2. Caitlin M. Cohan
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Corresponding author

Correspondence to Annie Tang.

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The authors report no conflict of interest in any product mentioned or concept discussed in this article. This study has not been presented or published.

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Tang, A., Cohan, C.M., Hansen, K.S. et al. Relationship between body mass index and malignancy rates of MRI-guided breast biopsies: impact of clinicodemographic factors. Breast Cancer Res Treat 188, 739–747 (2021). https://doi.org/10.1007/s10549-021-06189-5

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  • DOI: https://doi.org/10.1007/s10549-021-06189-5

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