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Lee, Kim, Gwak, Lee, Jang, Shin, Park, and Jung: Role of MRI in Diagnostic Evaluation of Papillary Lesions of the Breast
Original Contribution
Journal of the Korean Society of Magnetic Resonance in Medicine

Journal of the Korean Society of Magnetic Resonance in Medicine 2010; 14(1): 41-46.

Published online: 30 June 2010

DOI: https://doi.org/10.13104/jksmrm.2010.14.1.41

Role of MRI in Diagnostic Evaluation of Papillary Lesions of the Breast

So Mi Lee1, Hye Jung Kim1, Yeon Joo Gwak1, Hui Joong Lee1, Yun-Jin Jang1, Kyung Min Shin1, Ji Young Park2, Jin Hyang Jung3

1Department of Radiology, Kyungpook National University Hospital, Korea.

2Department of Pathology, Kyungpook National University Hospital, Korea.

3Department of Surgery, Kyungpook National University Hospital, Korea.

Address reprint requests to: Hye Jung Kim, M.D., Department of Radiology, Kyungpook National University Hospital, 200, Dongduk-ro, Jung-gu, Daegu 700-721, Korea. Tel. 82-53-420-5390, Fax. 82-53-422-2677, mamrad@knu.ac.kr

Received 23 October 2009       Revised 14 April 2010       Accepted 13 May 2010

Copyright © 2010 Korean Society of Magnetic Resonance in Medicine

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of papillary lesions of the breast.

Materials and Methods

Among 45 papillary lesions diagnosed at ultrasonography-guided core biopsy (USCB), 27 benign papillary lesions in 22 patients who underwent breast MRI were reviewed. The excsional biopsy was performed in 1-10 days after MRI was done. In MRI findings, lesions were considered suspicious if they show irregular, rim enhancement, or linear enhancement in morphologic evaluation, or washout enhancement pattern of delayed phase in dynamic enhancement characteristics. Diffusion-weighted images were analyzed according to visibility of lesions. MRI findings were correlated with pathologic results at excisional biopsy.

Results

At excisional biopsy, two lesions (9%) were diagnosed malignant in 22 benign papillary lesions without atypia by USCB and 4 (80%) were malignant in 5 benign papillary lesions with atypia by USCB. Among 18 lesions detected on MRI, 16 lesions showed suspicious findings on MRI, 11 lesions (69%) were diagnosed as benign and 5 (31%) were malignant. Among 12 lesions detected on diffusion weighted imaging, 10 lesions were diagnosed as benign and 2 were malignant. MRI findings were not significantly correlated with pathologic results at excisional biopsy.

Conclusion

MRI findings were not useful to predict malignancy in benign papillary lesions diagnosed at USCB, because MRI findings of these were mostly suspicious (88.9%, 16/18). The benign papillary lesion should be included in the false positive lesion on breast MRI.

Keywords: Breast neoplasm, Magnetic resonance (MR), Biopsy

Figures and Tables

Fig. 1
39-year-old woman with papilloma at US-guided core biopsy. (a) Subtraction image shows a irregular mass (arrow) and (b) ROI (region of interest) curve demonstrates initial rapid and washout enhancement pattern. (c) Diffusion-weighted image shows high signal intensity (arrow). After excisional biopsy, pathology revealed papilloma.
jksmrm-14-41-g001
Table 1
Pathologic Results at Excision of Benign Papillary Lesions Diagnosed by US-guided Core Biopsy and Excision
jksmrm-14-41-i001

*DCIS: Ductal carcinoma in situ

Table 2
MRI Findings and Pathologic Results at Excision of Benign Papillary Lesions Diagnosed by US-guided Core Biopsy
jksmrm-14-41-i002

*+: visible, ∆: not visible, ∫DCIS: ductal carcinoma in situ

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