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Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study

Purpose: To determine if MRI features and molecular subtype influence the detectability of breast cancers on MRI in high-risk patients. Methods and Materials: Breast cancers in a high-risk population of 104 patients were diagnosed following MRI describing a BI-RADS 4–5 lesion. MRI characteristics at...

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Autores principales: Bilocq-Lacoste, Julie, Ferre, Romuald, Kuling, Grey, Martel, Anne L., Tyrrell, Pascal N., Li, Siying, Wang, Guan, Curpen, Belinda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8879993/
https://www.ncbi.nlm.nih.gov/pubmed/35202192
http://dx.doi.org/10.3390/tomography8010027
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author Bilocq-Lacoste, Julie
Ferre, Romuald
Kuling, Grey
Martel, Anne L.
Tyrrell, Pascal N.
Li, Siying
Wang, Guan
Curpen, Belinda
author_facet Bilocq-Lacoste, Julie
Ferre, Romuald
Kuling, Grey
Martel, Anne L.
Tyrrell, Pascal N.
Li, Siying
Wang, Guan
Curpen, Belinda
author_sort Bilocq-Lacoste, Julie
collection PubMed
description Purpose: To determine if MRI features and molecular subtype influence the detectability of breast cancers on MRI in high-risk patients. Methods and Materials: Breast cancers in a high-risk population of 104 patients were diagnosed following MRI describing a BI-RADS 4–5 lesion. MRI characteristics at the time of diagnosis were compared with previous MRI, where a BI-RADS 1–2–3 lesion was described. Results: There were 77 false-negative MRIs. A total of 51 cancers were overlooked and 26 were misinterpreted. There was no association found between MRI characteristics, the receptor type and the frequency of missed cancers. The main factors for misinterpreted lesions were multiple breast lesions, prior biopsy/surgery and long-term stability. Lesions were mostly overlooked because of their small size and high background parenchymal enhancement. Among missed lesions, 50% of those with plateau kinetics on initial MRI changed for washout kinetics, and 65% of initially progressively enhancing lesions then showed plateau or washout kinetics. There were more basal-like tumours in BRCA1 carriers (50%) than in non-carriers (13%), p = 0.0001, OR = 6.714, 95% CI = [2.058–21.910]. The proportion of missed cancers was lower in BRCA carriers (59%) versus non-carriers (79%), p < 0.05, OR = 2.621, 95% CI = [1.02–6.74]. Conclusions: MRI characteristics or molecular subtype do not influence breast cancer detectability. Lesions in a post-surgical breast should be assessed with caution. Long-term stability does not rule out malignancy and multimodality evaluation is of added value. Lowering the biopsy threshold for lesions with an interval change in kinetics for a type 2 or 3 curve should be considered. There was a higher rate of interval cancers in BRCA 1 patients attributed to lesions more aggressive in nature.
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spelling pubmed-88799932022-02-26 Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study Bilocq-Lacoste, Julie Ferre, Romuald Kuling, Grey Martel, Anne L. Tyrrell, Pascal N. Li, Siying Wang, Guan Curpen, Belinda Tomography Article Purpose: To determine if MRI features and molecular subtype influence the detectability of breast cancers on MRI in high-risk patients. Methods and Materials: Breast cancers in a high-risk population of 104 patients were diagnosed following MRI describing a BI-RADS 4–5 lesion. MRI characteristics at the time of diagnosis were compared with previous MRI, where a BI-RADS 1–2–3 lesion was described. Results: There were 77 false-negative MRIs. A total of 51 cancers were overlooked and 26 were misinterpreted. There was no association found between MRI characteristics, the receptor type and the frequency of missed cancers. The main factors for misinterpreted lesions were multiple breast lesions, prior biopsy/surgery and long-term stability. Lesions were mostly overlooked because of their small size and high background parenchymal enhancement. Among missed lesions, 50% of those with plateau kinetics on initial MRI changed for washout kinetics, and 65% of initially progressively enhancing lesions then showed plateau or washout kinetics. There were more basal-like tumours in BRCA1 carriers (50%) than in non-carriers (13%), p = 0.0001, OR = 6.714, 95% CI = [2.058–21.910]. The proportion of missed cancers was lower in BRCA carriers (59%) versus non-carriers (79%), p < 0.05, OR = 2.621, 95% CI = [1.02–6.74]. Conclusions: MRI characteristics or molecular subtype do not influence breast cancer detectability. Lesions in a post-surgical breast should be assessed with caution. Long-term stability does not rule out malignancy and multimodality evaluation is of added value. Lowering the biopsy threshold for lesions with an interval change in kinetics for a type 2 or 3 curve should be considered. There was a higher rate of interval cancers in BRCA 1 patients attributed to lesions more aggressive in nature. MDPI 2022-02-02 /pmc/articles/PMC8879993/ /pubmed/35202192 http://dx.doi.org/10.3390/tomography8010027 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bilocq-Lacoste, Julie
Ferre, Romuald
Kuling, Grey
Martel, Anne L.
Tyrrell, Pascal N.
Li, Siying
Wang, Guan
Curpen, Belinda
Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study
title Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study
title_full Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study
title_fullStr Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study
title_full_unstemmed Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study
title_short Missed Breast Cancers on MRI in High-Risk Patients: A Retrospective Case–Control Study
title_sort missed breast cancers on mri in high-risk patients: a retrospective case–control study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8879993/
https://www.ncbi.nlm.nih.gov/pubmed/35202192
http://dx.doi.org/10.3390/tomography8010027
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