3D dynamic MRI in breast malignancies: Review of 480 cases

Purpose: To focus the main applications of dynamic 3D contrast enhanced MRI in breast malignancies by retrospective review of 500 cases. Materials and Methods: 480 cases of breast MRI, performed for different clinical queries and carried out on 1.5T unit by means of a standard protocol (3D FSPGR dynamic sequence, 1 serie pre and 7 series post contrast medium i.v. administration), were retrospectively reviewed. We have focused our attention on cases of malignancies, newly diagnosed (52 cases) or previously present (89), to evaluate the efficacy of MRI in early diagnosis and correct staging of breast cancer in selected cases. Results: 145 patients underwent MRI because of the mammographic finding of serious suspicion of breast cancer (nodule or microcalcifications), 89 for the evaluation of surgical scar, 28 because of the presence of dense breast, ultrasonographic dubious findings and familiar history of breast cancer. In 26/110 cases MRI found a malignancy corresponding to mammographic evidence of microcalcifications; in 30/35 patients with mammo/ultrasonographic finding of nodule suspect of malignancy, MRI confirmed the diagnosis: in 4 of these 30 cases MRI allowed a better staging of disease, detecting a multifocal/multicentric condition. Seven cases were breast cancers that were MR-only visible. Conclusions: On the basis of our experience breast MRI represents a usefull diagnostic tool, which should support mammography and ultrasonography in selected cases for the early diagnosis of breast cancer (recurrence on scar tissue, dense breast) and for a more correct staging of local disease.