Evaluation of malignant breast masses with abbreviated breast magnetic resonance imaging

Objectives: Our study aimed to investigate the sensitivity of the abbreviated magnetic resonance imaging (MRI) in the detection of tumors in breast cancer patients. Methods: Patients who underwent breast MRI between March 2018 and October 2021 were reviewed retrospectively. Patients with a histologic diagnosis of breast malignancy were included in the study. Patients who underwent a biopsy or an interventional procedure before the MRI examination and who received neoadjuvant chemotherapy were excluded from the study. Abbreviated MR protocol included a pre-contrast T1-weighted, 1st minute contrast-enhanced T1-weighted, and 1st minute subtracted series. Additionally, 2nd minute post-contrast series were evaluated. Results: A total of 83 lesions with a histologic diagnosis of breast cancer were evaluated in 81 patients. The mean age of the patients included in the study was 51.08 years (range: 27-79 years). Seventy-four of the 83 breast lesions showed contrast enhancement in the 1st minute contrast-enhanced images and subtraction images (sensitivity 89.1%). When missed cases were re-evaluated all of them were visible in the second-minute contrast-enhanced series. Conclusions: In this study, malignant lesions could be detected with high-sensitivity abbreviated MRI protocol and the addition of second-minute contrast-enhanced series to the protocol significantly improve lesion detection. We believe that MRI with the abbreviated MRI protocol can be used for screening purposes in high-risk women with dense breasts.

Keywords:

Breast cancer, magnetic resonance imaging, abbreviated MRI mammography, breast cancer screening,

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1. Bakker MF, de Lange SV, Pijnappel RM, Mann RM, Peeters PHM, Monninkhof EM, et al; DENSE Trial Study Group. Supplemental MRI screening for women with extremely dense breast tissue. N Engl J Med 2019;381:2091-102.
2. McCormack VA, dos Santos Silva I. Breast density and parenchymal as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2006;15:1159-69.
3. von Euler–Chelpin M, Lillholm M, Vejborg I, Nielsen M, Lynge E. Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark. Breast Cancer Res 2019;21:111.
4. Sardanelli F, Podo F. Breast MR imaging in women at high risk of breast cancer: is something changing in early breast cancer detection? Eur Radiol 2007;17:873-87.
5. Warner E, Plewes DB, Shumak RS, Catzavelos GC, Di Prospero LS, Yaffe MJ, et al. Comparison of breast magnetic resonance imaging, mammography, and ultrasound for surveillance of women at high risk for hereditary breast cancer. J Clin Oncol 2001;19:3524-31.
6. Kuhl CK, Strobel K, Bieling H, Leutner C, Schild HH, Schrading S. Supplemental breast MR imaging screening of women with an average risk of breast cancer. Radiology 2017;283:361-70.
7. Chen SQ, Huang M, Shen YY, Liu CL, Xu CX. Application of abbreviated protocol of magnetic resonance imaging for breast cancer screening in dense breast tissue. Acad Radiol 2017;24:316-20.
8. Berg WA, Zhang Z, Lehrer D, Jong RA, Pisano ED, Barr RG, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA 2012;307:1394-404.
9. Mann RM, Athanasiou A, Baltzer PAT, Camps-Herrero J, Clauser P, Fallenberg EM, et al. Breast cancer screening in women with extremely dense breasts recommendations of the European Society of Breast Imaging (EUSOBI). Eur Radiol 2022;32:4036-45.
10. Kuhl CK, Schrading S, Strobel K, Schild HH, Hilgers RD, Bieling HB. Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI. J Clin Oncol 2014;32 2304-10.
11. Mango VL, Morris EA, Dershaw DD, Abramson A, Fry C, Moskowitz CS, et al. Abbreviated protocol for breast MRI: are multiple sequences needed for cancer detection? Eur J Radiol 2015;84:65-70.
12. Hernandez ML, Osorio M, Florez K, Ospino A, Diaz GM. Abbreviated magnetic resonance imaging in breast cancer: A systematic review of literatüre. Eur J Radiol Open 2021;8:100307.
13. Grimm LJ, Soo MS, Yoon S, Kim C, Ghate SV, Johnson KS. Abbreviated screening protocol for breast MRI. a feasibility study. Acad. Radiol 2015;22:1157-62.
14. Yamada T, Kanemaki Y, Okamoto S, Nakajima Y. Comparison of detectability of breast cancer by abbreviated breast MRI based on diffusion-weighted images and postcontrast MRI. Jpn J Radiol 2018;36:331-9.
15. Dialani V, Tseng I, Slanetz PJ, Fein-Zachary V, Phillips J, Karimova E, et al. Potential role of abbreviated MRI for breast cancer screening in an academic medical center. Breast J 2019;25:604-11.
16. Bickelhaupt S, Tesdorff J, Laun FB, Kuder TA, Lederer W, Teiner S, et al. Independent value of image fusion in unenhanced breast MRI using diffusion-weighted and morphological T2-weighted images for lesion characterization in patients with recently detected BI-RADS 4/5 x-ray mammography findings. Eur Radiol 2017;27:562-9.
17. Panigrahi B, Mullen L, Falomo E, Panigrahi B, Harvey S. An abbreviated protocol for high-risk screening breast magnetic resonance imaging: impact on performance metrics and BI-RADS assessment. Acad Radiol 2017;24:1132-8.
18. Park KW, Han SB, Han BK, Ko ES, Choi JS, Rhee SJ, et al. MRI surveillance for women with a personal history of breast cancer: comparison between abbreviated and full diagnostic protocol. Br J Radiol 2020;93:20190733.
19. Kwon MR, Ko EY, Han BK, Ko ES, Choi JS, Park KW. Diagnostic performance of abbreviated breast MRI for screening of women with previously treated breast cancer. Medicine (Baltimore) 2020;99:e19676.