Sensitivity and specificity of MR mammography with histopathological correlation in 250 breasts

Abstract

Purpose: The aim of our prospective study was to determine the diagnostic accuracy of MR mammography (MRM) in detecting malignant disease.

Material and methods: In 231 consecutive patients scheduled for surgery because of mammographic or palpable lesions suspected of malignancy, the breasts were examined with T1-weighted transversal images using a 3-D fast low angle shot (FLASH) sequence. One pre- and 2 post-contrast images were obtained. Histological examination of the surgical specimens showed carcinoma in 155 breasts, of which 138 were invasive and 17 in situ.

Results: MRM detected 144 of the 155 malignancies and was false-negative in 11 cases. Eight of these MRM-missed tumours were invasive and 3 were in situ cancers. Benign lesions were found at microscopy in 95 breasts, of which MRM correctly diagnosed 69. The cellular composition of the 26 false-positive lesions (myxomatous stromal change, high vascularity, and epithelial or apocrine hyperplasia) might explain the false positivity. The sensitivity and specificity of MRM were 93% and 73% respectively.

Conclusion: MRM should be interpreted with caution, and supplemented with e.g. mammography and ultrasonography.