Title: Role of Magnetic Resonance Imaging in Non-Palpable Breast Cancer to Diagnose Breast Cancer with Stereo-Guided Biopsy
Abstract: Background: The prevalence of non-palpable breast cancer has increased since the introduction of breast screening programs, and stereo-guided biopsy plays an important role in diagnosing non-palpable breast cancer. Although magnetic resonance imaging (MRI) is useful in detecting breast cancer, the relationship between stereo-guided biopsy and MRI has not been systematically assessed. In addition, according to some studies, breast density provides false-negative breast cancer detection rates. Therefore, this study aimed to evaluate the role of MRI in performing stereo-guided biopsy, particularly its relationship with breast density. Materials and methods: In this study population, there were 274 non-palpable lesions (254 patients) as detected by mammography. The breast imaging reporting and data system (BI-RADS) classification was used to evaluate the breast density. The patients underwent stereo-guided biopsy in our hospital between January 2011 and September 2013. We assessed the utility of MRI before patients underwent stereo-guided biopsy and examined whether MRI should be performed. Results: Eighty lesions (29.2%) had breast cancer. The sensitivity and specificity of MRI were 53.3% and 92.4%, respectively. In dense lesions (BI-RADS category 3 and 4), negative predictive value (NPV) of MRI was low (77.2%) compared with thin breast tissue (86.2%; BI-RADS category 1 and 2). MRI revealed 20 malignant lesions, whereas breast ultrasound revealed no sign of malignancy. A total of 34 of 274 lesions (12.4%) for which both MRI and ultrasound were not able to detect malignancy had breast cancer (4 invasive ductal carcinoma, 30 ductal carcinoma in situ). Conclusions: We conclude that MRI may be beneficial to determine whether patients should undertake stereo-guided biopsy. NPV of MRI is comparatively low in dense breast tissues; therefore, these patients should undergo stereo-guided biopsy regardless of the negative MRI finding role of magnetic resonance imaging in non-palpable breast cancer to diagnose breast cancer with stereo-guided biopsy Disclosure: All authors have declared no conflicts of interest.