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. 2024 Aug;45(8):799-807.
doi: 10.15537/smj.2024.45.8.20230748.

Magnetic resonance imaging of the breast: Could it be used as a screening test?

Deema A Nagadi  1 , Naglaa M Elsayed  1
Affiliations

Magnetic resonance imaging of the breast: Could it be used as a screening test?

Deema A Nagadi et al. Saudi Med J. 2024 Aug.

Abstract

Objectives: To investigate whether magnetic resonance imaging (MRI) best detects early malignancy in high-risk women.

Methods: A retrospective, cross-sectional study, carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, included 419 female breast cancer patients aged 16-84 years (mean age of 49). Data were collected from the radiological department's database to compare the MRI, ultrasound (US), and mammography results, with or without tissue biopsy.

Results: In diagnosing benign versus malignant lesions, MRI showed significant agreement with tissue biopsy, with high sensitivity (70%) and specificity (87%); its positive predictive value (PPV) was 92% and negative predictive value (NPV) was 56%. While US has a PPV of 84% and NPV of 63%; with a sensitivity (79%) and specificity (71%). In patients without tissue biopsy, there was little difference between mammography and US compared with MRI results.

Conclusion: Magnetic resonance imaging is more effective than US and mammography for early detection of BC. It showed high sensitivity in detecting breast lesions and high specificity in characterizing their nature when correlated with pathological results. Ultrasound screening followed by MRI is suggested for undetected or suspected lesions. This will increase the breast lesion detection rate, reduce unneeded tissue biopsies, and enhance the disease's survival rate.

Keywords: MRI; US; breast cancer; histopathology; mammography; screening.

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Figures

Figure 1
Figure 1
- Algorithm showing the procedures carried out in all studied patients. MRI: magnetic resonance imaging, US: ultrasound
Figure 2
Figure 2
- Comparisons of the tissue biopsy results. a) Diagnostic performance of mammogram vs tissue biopsy. b) Diagnostic performance of magnetic resonance imaging vs tissue biopsy. c) Diagnostic performance of ultrasound vs tissue biopsy. Mammo: mammogram, PPV: positive predictive value, NPV: negative predictive value, MRI: magnetic resonance imaging, US: ultrasound
Figure 3
Figure 3
- Comparisons of ultrasound (US) and mammography results with magnetic resonance imaging (MRI). a) Diagnostic performance of US vs. MRI. b) Diagnostic performance of mammography vs. MRI. Mammo: mammogram, PPV: positive predictive value, NPV: negative predictive value, MRI: magnetic resonance imaging, US: ultrasound
See this image and copyright information in PMC

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