Punam Bajaj MD, MBBS, Presenter: Nothing to Disclose

Junting Zheng, Abstract Co-Author: Nothing to Disclose

D. David Dershaw MD, Abstract Co-Author: Nothing to Disclose

Chaya Moskowitz, Abstract Co-Author: Nothing to Disclose

Elizabeth A. Morris MD, Abstract Co-Author: Nothing to Disclose

To determine if suspicious breast MRI lesions proven to represent invasive ductal carcinoma with an ultrasound correlate are of different histological grade compared with ultrasound occult lesions.

Institutional review board approved retrospective study of 310 MRI examinations performed between 2008 and 2011 yielded 350 suspicious lesions for which biopsy was recommended. Subsequent high resolution targeted ultrasound was performed and histopathological grade of carcinomas was recorded as I (low), II (intermediate) or III (high). Statistical analysis was performed applying the Fisher's exact test ,Kruskal-Wallis test and exact Wilcoxon rank sum test. 

Targeted ultrasound demonstrated a correlate in 181/350 (52%) suspicious MRI lesions yielding 63/181 (35%) malignant lesions. The remaining 169 (48%) lesions which were sonographically occult, yielded 25/169 (15%) malignant lesions. Sonographic correlates were seen for 72% (63/88) of malignant lesions. Of these, 87% (55/63) were invasive carcinomas and 13% (8/63) were ductal carcinomas in situ. Histological grade was available for 46 invasive ductal carcinomas with ultrasound correlate (3(6.5%),13(28.3%) and 30(65.2%) were histological grade I,II and III, respectively)and 8 without correlate (4(50%),3(37.5%) and 1(12.5%) were histological grade I,II and III, respectively). There was no statistically significant difference in the size of tumors with or without an ultrasound correlate (p=0.163). In the group with an ultrasound correlate, no significant difference was observed in tumor size between the recorded histological grades (p=0.052). A grade III tumor was more likely to be present in the group with an ultrasound correlate (p <0.001).  

When a suspicious breast MRI lesion has an ultrasound correlate, it is more likely to represent invasive carcinoma of higher histological grade.  

The presence of an ultrasound correlate for a suspicious breast MRI lesion may indicate a more aggressive cancer.  

Bajaj, P, Zheng, J, Dershaw, D, Moskowitz, C, Morris, E, Are Suspicious Breast MRI Lesions with an Ultrasound Correlate Higher Histological Grade Tumors?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13023540.html