Simone Schrading MD, Presenter: Nothing to Disclose

Kevin Strobel PhD, Abstract Co-Author: Nothing to Disclose

Nienke Lynn Hansen MD, Abstract Co-Author: Nothing to Disclose

Christiane Katharina Kuhl MD, Abstract Co-Author: Advisory Board Member, Bayer AG

It is well established that some proliferative breast lesions (so called borderline or “high-risk” lesions) are associated with an increased risk of future breast cancer. We investigated the prevalence of such high-risk lesions in MR-guided versus mammography-guided biopsies .

Between 01-2011 and 12-2012, 439 MR guided vacuum biopsies for contrast enhancing lesions seen in breast MRI alone and 216 mammography-guided biopsies for suspicious mammographic findings, mainly suspicious microcalcifications, were performed. We investigated the fraction of proliferative high-risk lesions, such as atypical ductal (ADH) or lobular hyperplasia, LIN, flat epithelial hyperplasia (FEA), complex sclerosing lesion in MRI- versus mammography-guided biopsies.

A total 53% (232/439) of MR-guided biopsies and 62% (135/216) of mammography guided biopsies proved benign. Among the benign MR lesions, 29.7% (69/232) were high-risk lesions, with ADH in 43.5% (30/69), FEA in 39.1% (27/69), LIN in 11.6% (8/69) and complex sclerosing lesions in 5.8% (4/69). Among the benign mammographic lesions, 8.9% (12 /135) were high-risk lesions, with 66.7% (8/12) ADH and 33.3% (4/12) FEA.

The prevalence of high risk changes among non malignant breast lesions is significantly higher in MRI than in mammography. This needs to be considered when discussing the rate of “false positive” findings in breast MRI vs. mammography.

The biologic importance of benign lesions detected on the basis of contrast enhancement in MRI appears to be different from that of benign lesions detected on the basis of mammographically changes

Schrading, S, Strobel, K, Hansen, N, Kuhl, C, Biologic Significance of Benign Breast Biopsies Obtained under MRI vs. under Mammographic Guidance.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13044460.html