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Extra-mammary findings in breast MRI

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Abstract

Objectives

Incidental extra-mammary findings in breast Magnetic Resonance Imaging (MRI) may be benign in nature, but may also represent a metastasis or another important lesion. We aimed to analyse the prevalence and clinical relevance of these unexpected findings.

Methods

A retrospective review of 1535 breast MRIs was conducted. Only axial sequences were reassessed. Confirmation examinations were obtained in all cases.

Results

285 patients had a confirmed incidental finding, which were located in the liver (51.9%), lung (11.2%), bone (7%), mediastinal lymph nodes (4.2%) or consisted of pleural/pericardial effusion (15.4%). 20.4% of incidental findings were confirmed to be malignant. Positive predictive value for MRI to detect a metastatic lesion was high if located within the bone (89%), lymph nodes (83%) and lung (59%), while it was low if located within the liver (9%) or if it consisted of pleural/pericardial effusion (6%). The axial enhanced sequence showed superior sensitivity to unenhanced images in detecting metastatic lesions, especially if only smaller (≤10 mm.) lesions were considered.

Conclusions

The prevalence of metastatic incidental extra-mammary findings is not negligible. Particular attention should be to incidental findings located within the lung, bone and mediastinal lymph nodes.

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Authors and Affiliations

  1. Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168, Rome, Italy

    Pierluigi Rinaldi, M. Costantini, P. Belli, M. Giuliani, E. Bufi, R. Fubelli, D. Distefano, M. Romani & L. Bonomo

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  1. Pierluigi Rinaldi
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  2. M. Costantini
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  3. P. Belli
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  4. M. Giuliani
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  5. E. Bufi
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  6. R. Fubelli
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  7. D. Distefano
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  8. M. Romani
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  9. L. Bonomo
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Correspondence to Pierluigi Rinaldi.

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Rinaldi, P., Costantini, M., Belli, P. et al. Extra-mammary findings in breast MRI. Eur Radiol 21, 2268–2276 (2011). https://doi.org/10.1007/s00330-011-2183-6

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  • DOI: https://doi.org/10.1007/s00330-011-2183-6

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