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MRI-visualized T2 hyperintense breast lesions: identifying clinical and imaging factors linked to malignant biopsy outcomes

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

Abstract

Purpose

To determine the malignancy rate for MRI-guided breast biopsies performed for T2 hyperintense breast lesions and to assess additional clinical and MRI characteristics that can predict benign and malignant outcomes.

Methods

A retrospective chart review of consecutive MRI-guided breast biopsies performed in two tertiary hospitals was conducted over two years. Biopsies performed for T2 hyperintense lesions were selected, and further lesion imaging characteristics and patient risk factors were collected. Univariate and multivariate modeling regression were used to determine additional imaging and patient factors associated with malignant outcomes for biopsies of T2 hyperintense lesions.

Results

Out of 369 MRI-guided breast biopsies, 100 (27%) were performed for T2 hyperintense lesions. Two biopsy-proven benign lesions were excluded as the patient was lost on follow-up. With a study cohort of 98 lesions, the final pathology results were benign for 80 (80%) of these lesions, while 18 (18%) were malignant. Using multivariate logistic modeling, patient age > 50 (OR 5.99 (1.49, 24.08 95% CI), p < 0.05) and lesion size > 3 cm (OR 5.54 (1.54–18.7), p < 0.01) were found to be important predictors of malignant outcomes for MRI biopsies performed for T2 hyperintense lesions.

Conclusion

Our study observed a high malignancy rate, challenging the assumption that T2 hyperintensity can be considered a benign imaging characteristic for otherwise suspicious MRI-detected lesions. Decision-making regarding tissue sampling should be made based on a thorough evaluation of more reliable additional demographic and imaging factors, including patient age and lesion size.

Key messages

  • Increasing patient age and increasing target lesion size are important predictors of a malignant breast biopsy for T2 hyperintense lesions.

  • Lesion T2 intensity should be assessed for every target; however, additional imaging and clinical features should be used to guide decision-making regarding the need for tissue sampling.

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Data availability

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

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, 501 Smyth Rd, Ottawa, ON, K1S 2H6, Canada

    Mary Beth Bissell

  2. Department of Biostatistics, Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2M9, Canada

    Sareh Keshavarsi

  3. Department of Radiology, University of Toronto, 610 University Ave, Toronto, ON, M5G 2M9, Canada

    Rachel Fleming, Frederick Au, Supriya Kulkarni, Sandeep Ghai & Vivianne Freitas

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  1. Mary Beth Bissell
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Contributions

All authors contributed to the study's conception and design. MBB, VF, and SK performed material preparation, data collection, and analysis. MBB wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Vivianne Freitas.

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Bissell, M.B., Keshavarsi, S., Fleming, R. et al. MRI-visualized T2 hyperintense breast lesions: identifying clinical and imaging factors linked to malignant biopsy outcomes. Breast Cancer Res Treat 205, 159–168 (2024). https://doi.org/10.1007/s10549-023-07239-w

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  • DOI: https://doi.org/10.1007/s10549-023-07239-w

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