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. 2024 Apr 6:57:e20230111en.
doi: 10.1590/0100-3984.2023.0111-en. eCollection 2024 Jan-Dec.

Analysis of the indications for and results of breast cancer screening by magnetic resonance imaging at a cancer center in Brazil

Karina Kuhl Zoghbi  1   2 , Vinicius Cardona Felipe  3 , Luciana Graziano  3 , Camila Souza Guatelli  3 , Juliana Alves de Souza  3 , Almir Galvão Vieira Bitencourt  3
Affiliations

Analysis of the indications for and results of breast cancer screening by magnetic resonance imaging at a cancer center in Brazil

Karina Kuhl Zoghbi et al. Radiol Bras. .

Abstract
in English, Portuguese

Objective: To evaluate the indications for and results of magnetic resonance imaging (MRI) examinations for breast cancer screening at a cancer center in Brazil.

Materials and methods: This was a retrospective observational study, based on electronic medical records, of patients undergoing MRI for breast cancer screening at a cancer center in Brazil.

Results: We included 597 patients between 19 and 82 years of age. The main indications for MRI screening were a personal history of breast cancer, in 354 patients (59.3%), a family history of breast cancer, in 102 (17.1%), and a confirmed genetic mutation, in 67 (11.2%). The MRI result was classified, in accordance with the categories defined in the Breast Imaging Reporting and Data System, as benign (category 1 or 2), in 425 patients (71.2%), probably benign (category 3), in 143 (24.0%), or suspicious (category 4 or 5), in 29 (4.9%). On MRI, 11 malignant tumors were identified, all of which were invasive carcinomas. Among those 11 carcinomas, six (54.5%) were categorized as minimal cancers (< 1 cm), and the axillary lymph nodes were negative in 10 (90.9%). The cancer detection rate was 18.4/1,000 examinations, and the positive predictive value for suspicious lesions submitted to biopsy was 37.9%.

Conclusion: In our sample, the main indication for breast MRI screening was a personal history of breast cancer. The results indicate that MRI is a highly accurate method for the early detection of breast neoplasms in this population.

Objetivo: Avaliar as indicações e resultados de exames de ressonância magnética (RM) para rastreamento de câncer de mama em um centro oncológico no Brasil.

Materiais e métodos: Estudo observacional, realizado mediante análise retrospectiva de pacientes submetidos a RM das mamas para rastreamento de câncer de mama, por meio de revisão do prontuário eletrônico em um centro oncológico.

Resultados: Foram incluídas 597 pacientes com idade variando de 19 a 82 anos. As principais indicações para rastreamento foram história pessoal de câncer de mama em 354 (59,3%) pacientes, história familiar em 102 (17,1%) e mutação genética confirmada em 67 (11,2%). O resultado da RM foi benigno (BI-RADS 1 ou 2) em 425 (71,2%) pacientes, provavelmente benigno (BI-RADS 3) em 143 (24,0%) e suspeito (BI-RADS 4 ou 5) em 29 (4,9%). Foram identificados 11 tumores malignos na RM, todos carcinomas invasivos, porcentagem de cânceres “mínimos” (< 1 cm) de 54,5% e porcentagem de axila negativa de 90,9%. A taxa de detecção de câncer na RM foi 18,4/1000 exames e o valor preditivo positivo para as lesões suspeitas submetidas a biópsia foi 37,9%.

Conclusão: A principal indicação para RM de rastreamento na nossa população foi história pessoal de câncer de mama. Os resultados mostraram que a RM constitui um método com alta acurácia para detecção precoce de neoplasias da mama nessa população.

Keywords: Breast neoplasms/diagnostic imaging; Early detection of cancer/methods; Magnetic resonance imaging/methods; Mammography; Mass screening.

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Figures

Figure 1
Figure 1
A 42-year-old patient who underwent mammography and MRI for breast cancer screening. MRI (A–C) showing an 8-mm mass in the inferomedial quadrant of the right breast (arrow and circles) that had not been identified on mammography (D,E) and was confirmed to be invasive breast carcinoma after biopsy.
See this image and copyright information in PMC

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