La radiologia medica

, Volume 119, Issue 6, pp 393–399 | Cite as

Role of magnetic resonance imaging in probably benign (BI-RADS category 3) microcalcifications of the breast

  • Anna LindaEmail author
  • Chiara Zuiani
  • Viviana Londero
  • Eleonora Di Gaetano
  • Anna Dal Col
  • Rossano Girometti
  • Massimo Bazzocchi
Breast Radiology



This study was undertaken to evaluate whether magnetic resonance (MR) imaging is able to rule out malignancy in the case of BI-RADS 3 microcalcifications, providing a sufficient negative predictive value (NPV) for early work-up, and to reduce unnecessary stereotactically guided vacuum-assisted biopsy (SVAB) procedures.

Materials and methods

We prospectively enrolled consecutive women with BI-RADS 3 microcalcifications, who subsequently underwent MR imaging and SVAB. The MR studies were reviewed according to the MR-BI-RADS classification system; lesions assessed as MR-BI-RADS 1 and 2 were considered negative for malignancy, categories MR-BI-RADS 3, 4 and 5 indicated malignant lesions. The presence of additional findings was recorded. Histologic analysis and follow-up were the reference standard. MR sensitivity, specificity, positive predictive value (PPV) and NPV were calculated.


The final population consisted of 71 lesions. Histologic analysis showed malignancy in six cases (malignancy rate 8 %). At MR analysis, 60 (85 %) lesions were considered negative for malignancy and 11 (15 %) malignant. Additional MR imaging findings were identified in 19 (27 %) patients, all corresponding to nonmalignant lesions. MR sensitivity was 33 %, specificity 86 %, PPV 18 % and NPV 93 %.


Because of its relatively low NPV, MR imaging is not able to safely exclude malignancy in the case of BI-RADS 3 microcalcifications. The relatively high malignancy rate found in this study might support SVAB in the case of BI-RADS 3 microcalcifications.


BI-RADS 3 Microcalcifications Breast MRI Stereotactically guided vacuum-assisted-biopsy DCIS 


Conflict of interest

Anna Linda, Chiara Zuiani, Viviana Londero, Eleonora Di Gaetano, Anna Dal Col, Rossano Girometti, Massimo Bazzocchi declare that they have no conflict of interest related to the publication of this article.


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Copyright information

© Italian Society of Medical Radiology 2013

Authors and Affiliations

  • Anna Linda
    • 1
    Email author
  • Chiara Zuiani
    • 1
  • Viviana Londero
    • 1
  • Eleonora Di Gaetano
    • 1
  • Anna Dal Col
    • 1
  • Rossano Girometti
    • 1
  • Massimo Bazzocchi
    • 1
  1. 1.Institute of Diagnostic RadiologyAzienda Ospedaliero-Universitaria Santa Maria della MisericordiaUdineItaly

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