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False-positive incidental lesions detected on contrast-enhanced breast MRI: clinical and imaging features

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

Abstract

Purpose

To identify demographic and imaging features of MRI-detected enhancing lesions without clinical, ultrasound, and mammographic correlation associated with false-positive outcomes, impacting patient care.

Materials and methods

A retrospective multi-institutional study of imaging studies and patient’s chart review of consecutive women with MRI-detected enhancing lesions without clinical, mammogram, or ultrasound correlation between January and December 2018, who underwent MRI-guided biopsy. According to the BI-RADS lexicon, lesions’ frequency and imaging features were recorded. The demographic and imaging characteristics variables were correlated with histopathology as the gold standard and an uneventful follow-up of at least one year. Univariate logistic regression analysis was used to explore the correlation between the baseline variables such as age, genetic mutation, family history of breast cancer, personal history of breast cancer, MRI indication, background parenchymal enhancement, and MRI characteristic of the lesion with the false-positive results in main data and subgroup analysis.

Results

Two hundred nineteen women (median age 49 years; range 26–85 years) with 219 MRI-detected enhancing lesions that underwent MRI-guided vacuum-assisted biopsy during the study period fulfilled the study criteria and formed the study cohort. Out of 219, 180 lesions (82.2%) yielded benign pathology results, including 137 benign outcomes (76%) and 43 high-risk lesions (24%). Most demographic and imaging characteristics variables did not help to differentiate malignant from benign lesions. The variables that showed statistically significant association with true-positive results in univariate analyses were age (OR 1.05; 95% CI 1.02–1.08; p = 0.0015), irregular mass-lesion shape when compared with oval/round mass lesion (OR 11.2; 95% CI 1.6–78.4; p = 0.015), and clumped and clustered ring of enhancement when compared with homogeneous (OR 3.22, 95% CI 1.40–7.40; p = 0.0058). For participants with mass breast lesion, the hyperintense signal on the T2-weighted sequence (compared to the normal fibroglandular signal) was significantly related to the false-positive result (OR 0.13; 95% CI 0.02–0.76; p = 0.024).

Conclusion

Young patients, oval/round mass-lesion shape, and homogeneous pattern of non-mass enhancement showed the strongest association with false-positive results of enhancing lesions depicted by MRI. For participants with mass breast lesion, T2-bright mass lesion showed significant association with false-positive result. It may impact the patient’s management with a suggestion of follow-up rather than interventional procedure when these demographic and imaging parameters are present, consequently decreasing the patient’s anxiety and health care costs.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors declare that no funds, grants, or other supports were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Division of Breast Imaging, Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada

    Afsaneh Alikhassi

  2. Department of Biostatistics—Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, 10Th Floor, Room 10-509, Toronto, ON, M5G 2M9, Canada

    Xuan Li

  3. Joint Department of Medical Imaging—University Health Network, Sinai Health System, Women’s College Hospital, University of Toronto, 610 University Avenue, Toronto, ON, M5G 2M9, Canada

    Frederick Au, Supriya Kulkarni, Sandeep Ghai, Grant Allison & Vivianne Freitas

Authors
  1. Afsaneh Alikhassi
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  2. Xuan Li
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  3. Frederick Au
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  4. Supriya Kulkarni
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  5. Sandeep Ghai
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  7. Vivianne Freitas
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by AA, VF, and XL. The first draft of the manuscript was written by AA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Vivianne Freitas.

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Competing interests

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University Health Network (May 14, 2020/REB#20-5119.0).

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As a retrospective study, the patient’s informed consent and also consent to publish was waived.

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Alikhassi, A., Li, X., Au, F. et al. False-positive incidental lesions detected on contrast-enhanced breast MRI: clinical and imaging features. Breast Cancer Res Treat 198, 321–334 (2023). https://doi.org/10.1007/s10549-023-06861-y

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  • DOI: https://doi.org/10.1007/s10549-023-06861-y

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