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01.08.2011 | Breast

Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics

verfasst von: Wendy B. DeMartini, Brenda F. Kurland, Robert L. Gutierrez, C. Craig Blackmore, Sue Peacock, Constance D. Lehman

Erschienen in: European Radiology | Ausgabe 8/2011

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Abstract

Objectives

To predict the probability of malignancy for MRI-detected breast lesions with a multivariate model incorporating patient and lesion characteristics.

Methods

Retrospective review of 2565 breast MR examinations from 1/03–11/06. BI-RADS 3, 4 and 5 lesions initially detected on MRI for new cancer or high-risk screening were included and outcomes determined by imaging, biopsy or tumor registry linkage. Variables were indication for MRI, age, lesion size, BI-RADS lesion type and kinetics. Associations with malignancy were assessed using generalized estimating equations and lesion probabilities of malignancy were calculated.

Results

855 lesions (155 malignant, 700 benign) were included. Strongest associations with malignancy were for kinetics (washout versus persistent; OR 4.2, 95% CI 2.5–7.1) and clinical indication (new cancer versus high-risk screening; OR 3.0, 95% CI 1.7–5.1). Also significant were age > = 50 years, size > = 10 mm and lesion-type mass. The most predictive model (AUC 0.70) incorporated indication, size and kinetics. The highest probability of malignancy (41.1%) was for lesions on MRI for new cancer, > = 10 mm with washout. The lowest (1.2%) was for lesions on high-risk screening, <10 mm with persistent kinetics.

Conclusions

A multivariate model shows promise as a decision support tool in predicting malignancy for MRI-detected breast lesions.

Harms SE, Flamig DP (1993) MR imaging of the breast: technical approach and clinical experience. Radiographics 13:905–912PubMed

Orel SG, Schnall MD, Powell CM et al (1995) Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. Radiology 196:115–122PubMed

Mumtaz H, Hall-Craggs MA, Davidson T et al (1997) Staging of symptomatic primary breast cancer with MR imaging. AJR Am J Roentgenol 169:417–424PubMed

Fischer U, Kopka L, Grabbe E (1999) Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology 213:881–888PubMed

Bedrosian I, Mick R, Orel SG et al (2003) Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer 98:468–473PubMedCrossRef

Liberman L, Morris EA, Dershaw DD, Abramson AF, Tan LK (2003) MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol 180:901–910PubMed

Schelfout K, Van Goethem M, Kersschot E et al (2004) Contrast-enhanced MR imaging of breast lesions and effect on treatment. Eur J Surg Oncol 30:501–507PubMedCrossRef

Schnall MD, Blume J, Bluemke DA et al (2005) MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883. J Surg Oncol 92:32–38PubMedCrossRef

Tan JE, Orel SG, Schnall MD, Schultz DJ, Solin LJ (1999) Role of magnetic resonance imaging and magnetic resonance imaging-guided surgery in the evaluation of patients with early-stage breast cancer for breast conservation treatment. Am J Clin Oncol 22:414–418PubMedCrossRef

10.

Tillman GF, Orel SG, Schnall MD, Schultz DJ, Tan JE, Solin LJ (2002) Effect of breast magnetic resonance imaging on the clinical management of women with early-stage breast carcinoma. J Clin Oncol 20:3413–3423PubMedCrossRef

11.

Berg WA, Gutierrez L, NessAiver MS et al (2004) Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology 233:830–849PubMedCrossRef

12.

Kim do Y, Moon WK, Cho N et al (2007) MRI of the breast for the detection and assessment of the size of ductal carcinoma in situ. Korean J Radiol 8:32–39PubMedCrossRef

13.

Hollingsworth AB, Stough RG, O’Dell CA, Brekke CE (2008) Breast magnetic resonance imaging for preoperative locoregional staging. Am J Surg 196:389–397PubMedCrossRef

14.

Sardanelli F, Giuseppetti GM, Panizza P et al (2004) Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in Fatty and dense breasts using the whole-breast pathologic examination as a gold standard. AJR Am J Roentgenol 183:1149–1157PubMed

15.

Hlawatsch A, Teifke A, Schmidt M, Thelen M (2002) Preoperative assessment of breast cancer: sonography versus MR imaging. AJR Am J Roentgenol 179:1493–1501PubMed

16.

Bagley FH (2004) The role of magnetic resonance imaging mammography in the surgical management of the index breast cancer. Arch Surg 139:380–383, discussion 383PubMedCrossRef

17.

Houssami NCS, Macaskill P, Lord SJ, Warren RM, Dixon JM, Irwig L (2008) Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer. J Clin Oncol 26:3248–3258PubMedCrossRef

18.

Rieber A, Merkle E, Bohm W, Brambs HJ, Tomczak R (1997) MRI of histologically confirmed mammary carcinoma: clinical relevance of diagnostic procedures for detection of multifocal or contralateral secondary carcinoma. J Comput Assist Tomogr 21:773–779PubMedCrossRef

19.

Slanetz PJ, Edmister WB, Yeh ED, Talele AC, Kopans DB (2002) Occult contralateral breast carcinoma incidentally detected by breast magnetic resonance imaging. Breast J 8:145–148PubMedCrossRef

20.

Liberman L, Morris EA, Kim CM et al (2003) MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer. AJR Am J Roentgenol 180:333–341PubMed

21.

Lee SG, Orel SG, Woo IJ et al (2003) MR imaging screening of the contralateral breast in patients with newly diagnosed breast cancer: preliminary results. Radiology 226:773–778PubMedCrossRef

22.

Viehweg P, Rotter K, Laniado M et al (2004) MR imaging of the contralateral breast in patients after breast-conserving therapy. Eur Radiol 14:402–408PubMedCrossRef

23.

Pediconi F, Catalano C, Roselli A et al (2007) Contrast-enhanced MR mammography for evaluation of the contralateral breast in patients with diagnosed unilateral breast cancer or high-risk lesions. Radiology 243:670–680PubMedCrossRef

24.

Lehman CD, Blume JD, Thickman D et al (2005) Added cancer yield of MRI in screening the contralateral breast of women recently diagnosed with breast cancer: results from the International Breast Magnetic Resonance Consortium (IBMC) trial. J Surg Oncol 92:9–15, discussion 15–16PubMedCrossRef

25.

Lehman CD, Gatsonis C, Kuhl CK et al (2007) MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med 356:1295–1303PubMedCrossRef

26.

Tilanus-Linthorst MM, Bartels CC, Obdeijn AI, Oudkerk M (2000) Earlier detection of breast cancer by surveillance of women at familial risk. Eur J Cancer 36:514–519PubMedCrossRef

27.

Podo F, Sardanelli F, Canese R et al (2002) The Italian multi-centre project on evaluation of MRI and other imaging modalities in early detection of breast cancer in subjects at high genetic risk. J Exp Clin Cancer Res 21(3 Suppl):115–124PubMed

28.

Morris EA, Liberman L, Ballon DJ et al (2003) MRI of occult breast carcinoma in a high-risk population. AJR Am J Roentgenol 181:619–626PubMed

29.

Kriege M, Brekelmans CT, Boetes C et al (2004) Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. N Engl J Med 351:427–437PubMedCrossRef

30.

Warner E, Plewes DB, Hill KA et al (2004) Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA 292:1317–1325PubMedCrossRef

31.

Kuhl CK, Schrading S, Leutner CC et al (2005) Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol 23:8469–8476PubMedCrossRef

32.

Lehman CD, Blume JD, Weatherall P et al (2005) Screening women at high risk for breast cancer with mammography and magnetic resonance imaging. Cancer 103:1898–1905PubMedCrossRef

33.

Leach MO, Boggis CR, Dixon AK et al (2005) Screening with magnetic resonance imaging and mammography of a UK population at high familial risk of breast cancer: a prospective multicentre cohort study (MARIBS). Lancet 365:1769–1778PubMedCrossRef

34.

Sardanelli F, Podo F, D’Agnolo G et al (2007) Multicenter comparative multimodality surveillance of women at genetic-familial high risk for breast cancer (HIBCRIT study): interim results. Radiology 242:698–715PubMedCrossRef

35.

Stomper PC, Waddell BE, Edge SB, Klippenstein DL (1999) Breast MRI in the evaluation of patients with occult primary breast carcinoma. Breast J 5:230–234PubMedCrossRef

36.

Henry-Tillman RS, Harms SE, Westbrook KC, Korourian S, Klimberg VS (1999) Role of breast magnetic resonance imaging in determining breast as a source of unknown metastatic lymphadenopathy. Am J Surg 178:496–500PubMedCrossRef

37.

Orel SG, Weinstein SP, Schnall MD et al (1999) Breast MR imaging in patients with axillary node metastases and unknown primary malignancy. Radiology 212:543–549PubMed

38.

Obdeijn IM, Brouwers-Kuyper EM, Tilanus-Linthorst MM, Wiggers T, Oudkerk M (2000) MR imaging-guided sonography followed by fine-needle aspiration cytology in occult carcinoma of the breast. AJR Am J Roentgenol 174:1079–1084PubMed

39.

Olson JA Jr, Morris EA, Van Zee KJ, Linehan DC, Borgen PI (2000) Magnetic resonance imaging facilitates breast conservation for occult breast cancer. Ann Surg Oncol 7:411–415PubMedCrossRef

40.

Buchanan CL, Morris EA, Dorn PL, Borgen PI, Van Zee KJ (2005) Utility of breast magnetic resonance imaging in patients with occult primary breast cancer. Ann Surg Oncol 12:1045–1053PubMedCrossRef

41.

ACR (2003) ACR BI-RADS®—MRI. ACR breast imaging reporting and data system, breast imaging atlas. American College of Radiology, Reston

42.

Kaiser WA, Zeitler E (1989) MR imaging of the breast: fast imaging sequences with and without Gd-DTPA. Preliminary observations. Radiology 170(3 Pt 1):681–686PubMed

43.

Harms SE, Flamig DP, Hesley KL et al (1993) MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. Radiology 187:493–501PubMed

44.

Boetes C, Barentsz JO, Mus RD et al (1994) MR characterization of suspicious breast lesions with a gadolinium-enhanced TurboFLASH subtraction technique. Radiology 193:777–781PubMed

45.

Heywang-Kobrunner SH, Viehweg P, Heinig A, Kuchler C (1997) Contrast-enhanced MRI of the breast: accuracy, value, controversies, solutions. Eur J Radiol 24:94–108PubMedCrossRef

46.

Orel SG, Schnall MD (2001) MR imaging of the breast for the detection, diagnosis, and staging of breast cancer. Radiology 220:13–30PubMed

47.

Gilles R, Guinebretiere JM, Lucidarme O et al (1994) Nonpalpable breast tumors: diagnosis with contrast-enhanced subtraction dynamic MR imaging. Radiology 191:625–631PubMed

48.

Heywang SH, Wolf A, Pruss E, Hilbertz T, Eiermann W, Permanetter W (1989) MR imaging of the breast with Gd-DTPA: use and limitations. Radiology 171:95–103PubMed

49.

Perman WH, Heiberg EM, Grunz J, Herrmann VM, Janney CG (1994) A fast 3D-imaging technique for performing dynamic Gd-enhanced MRI of breast lesions. Magn Reson Imaging 12:545–551PubMedCrossRef

50.

Kelcz F, Santyr GE, Cron GO, Mongin SJ (1996) Application of a quantitative model to differentiate benign from malignant breast lesions detected by dynamic, gadolinium-enhanced MRI. J Magn Reson Imaging 6:743–752PubMedCrossRef

51.

Kuhl CK, Mielcareck P, Klaschik S et al (1999) Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 211:101–110PubMed

52.

Hulka CA, Smith BL, Sgroi DC et al (1995) Benign and malignant breast lesions: differentiation with echo-planar MR imaging. Radiology 197:33–38PubMed

53.

Liberman L, Morris EA, Lee MJ et al (2002) Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol 179:171–178PubMed

54.

Wang LC, DeMartini WB, Partridge SC, Peacock S, Lehman CD (2009) MRI-detected suspicious breast lesions: predictive values of kinetic features measured by computer-aided evaluation. AJR Am J Roentgenol 193:826–831PubMedCrossRef

55.

Bassett LW, Dhaliwal SG, Eradat J, Khan O, Farria DF, Brenner RJ, Sayre JW (2008) National trends and practices in breast MRI. AJR Am J Roentgenol 191:332–339PubMedCrossRef

56.

Levine D, Bankier AA, Halpern EF (2009) Submissions to radiology: our top 10 list of statistical errors. Radiology 253:288–290CrossRef

57.

Liang KY, Zeger SL (1986) Longitudinal data analysis using generalized linear models. Biometrika 73:13–22CrossRef

58.

Hanley JA, McNeil BJ (1983) A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 148:839–843PubMed

59.

Hammill BGPJ (2006) A SAS/IML software program for GEE and regression diagnostics. Comput Stat Data Anal 51:1197–1212CrossRef

60.

Gonen M (2008) Analyzing receiver operating characteristic curves with SAS. SAS, Cary

61.

Fischer U, Kopka L, Brinck U, Korabiowska M, Schauer A, Grabbe E (1997) Prognostic value of contrast-enhanced MR mammography in patients with breast cancer. Eur Radiol 7:1002–1005PubMedCrossRef

62.

Gutierrez RL, Demartini WB, Eby P, Kurland BF, Peacock S, Lehman CD (2009) Clinical indication and patient age predict likelihood of malignancy in suspicious breast MRI lesions. Acad Radiol 16:1281–1285. doi:10.1016/j.acra.2009.04.012 PubMedCrossRef

63.

Gutierrez RL, DeMartini WB, Eby PR, Kurland BF, Peacock S, Lehman CD (2009) BI-RADS lesion characteristics predict likelihood of malignancy in breast MRI for masses but not for nonmasslike enhancement. AJR Am J Roentgenol 193:994–1000. doi:10.2214/AJR.08.1983 PubMedCrossRef

64.

Schnall MD, Blume J, Bluemke DA et al (2006) Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 238:42–53PubMedCrossRef

65.

Han BK, Schnall MD, Orel SG, Rosen M (2008) Outcome of MRI-guided breast biopsy. AJR Am J Roentgenol 191:1798–1804. doi:10.2214/AJR.07.2827 PubMedCrossRef

66.

Liberman L, Mason G, Morris EA, Dershaw DD (2006) Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol 186:426–430PubMedCrossRef

Titel: Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics
verfasst von: Wendy B. DeMartini
Brenda F. Kurland
Robert L. Gutierrez
C. Craig Blackmore
Sue Peacock
Constance D. Lehman
Publikationsdatum: 01.08.2011
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 8/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-011-2094-6

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Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics

Abstract

Objectives

Methods

Results

Conclusions

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Objectives

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