Frequency and Cancer Yield of BI-RADS Category 3 Lesions Detected at High-Risk Screening Breast MRI

2020 ◽  
Vol 214 (2) ◽  
pp. 240-248
Author(s):  
Christine E. Edmonds ◽  
Leslie R. Lamb ◽  
Sarah F. Mercaldo ◽  
Dorothy A. Sippo ◽  
Kristine S. Burk ◽  
...  
Keyword(s):  
High Risk ◽  
Breast Mri ◽  
Risk Screening ◽  
High Risk Screening

scholarly journals The Kaiser score reliably excludes malignancy in benign contrast-enhancing lesions classified as BI-RADS 4 on breast MRI high-risk screening exams

2020 ◽  
Vol 30 (11) ◽  
pp. 6052-6061 ◽  
Author(s):  
Ruxandra Iulia Milos ◽  
Francesca Pipan ◽  
Anastasia Kalovidouri ◽  
Paola Clauser ◽  
Panagiotis Kapetas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Diagnostic Accuracy ◽  
Breast Mri ◽  
Histopathological Diagnosis ◽  
Risk Screening ◽  
High Risk Patients ◽  
Risk Patients ◽  
Malignant Lesions ◽  
High Risk Screening

Abstract Objectives MRI is an integral part of breast cancer screening in high-risk patients. We investigated whether the application of the Kaiser score, a clinical decision-support tool, may be used to exclude malignancy in contrast-enhancing lesions classified as BI-RADS 4 on breast MRI screening exams. Methods This retrospective study included 183 consecutive, histologically proven, suspicious (MR BI-RADS 4) lesions detected within our local high-risk screening program. All lesions were evaluated according to the Kaiser score for breast MRI by three readers blinded to the final histopathological diagnosis. The Kaiser score ranges from 1 (lowest, cancer very unlikely) to 11 (highest, cancer very likely) and reflects increasing probabilities of malignancy, with scores greater than 4 requiring biopsy. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic accuracy. Results There were 142 benign and 41 malignant lesions, diagnosed in 159 patients (mean age, 43.6 years). Median Kaiser scores ranged between 2 and 5 in benign and 7 and 8 in malignant lesions. For all lesions, the Kaiser score’s accuracy, represented by the area under the curve (AUC), ranged between 86.5 and 90.2. The sensitivity of the Kaiser score was high, between 95.1 and 97.6% for all lesions, and was best in mass lesions. Application of the Kaiser score threshold for malignancy (≤ 4) could have potentially avoided 64 (45.1%) to 103 (72.5%) unnecessary biopsies in 142 benign lesions previously classified as BI-RADS 4. Conclusions The use of Kaiser score in high-risk MRI screening reliably excludes malignancy in more than 45% of contrast-enhancing lesions classified as BI-RADS 4. Key Points • The Kaiser score shows high diagnostic accuracy in identifying malignancy in contrast-enhancing lesions in patients undergoing high-risk screening for breast cancer. • The application of the Kaiser score may avoid > 45% of unnecessary breast biopsies in high-risk patients. • The Kaiser score aids decision-making in high-risk breast cancer MRI screening programs.

An Abbreviated Protocol for High-Risk Screening Breast MRI Saves Time and Resources

2016 ◽  
Vol 13 (11) ◽  
pp. R74-R80 ◽  
Author(s):  
Susan C. Harvey ◽  
Phillip A. Di Carlo ◽  
Bonmyong Lee ◽  
Eniola Obadina ◽  
Dorothy Sippo ◽  
...  
Keyword(s):  
High Risk ◽  
Breast Mri ◽  
Risk Screening ◽  
High Risk Screening

An Abbreviated Protocol for High-Risk Screening Breast MRI Saves Time and Resources

2016 ◽  
Vol 13 (4) ◽  
pp. 374-380 ◽  
Author(s):  
Susan C. Harvey ◽  
Phillip A. Di Carlo ◽  
Bonmyong Lee ◽  
Eniola Obadina ◽  
Dorothy Sippo ◽  
...  
Keyword(s):  
High Risk ◽  
Breast Mri ◽  
Risk Screening ◽  
High Risk Screening

Report of the Working Groups on Breast MRI: Report of the High-Risk Screening Group

2004 ◽  
Vol 10 (s2) ◽  
pp. S9-S12 ◽  
Author(s):  
Constance D. Lehman ◽  
Mitchel D. Schnall ◽  
Christiane K. Kuhl ◽  
Steven E. Harms
Keyword(s):  
High Risk ◽  
Breast Mri ◽  
Risk Screening ◽  
Working Groups ◽  
High Risk Screening

An Alternative Approach to Selecting Patients for High-risk Screening with Breast MRI

2014 ◽  
Vol 20 (2) ◽  
pp. 192-197 ◽  
Author(s):  
Alan B. Hollingsworth ◽  
Rebecca G. Stough
Keyword(s):  
High Risk ◽  
Breast Mri ◽  
Risk Screening ◽  
Alternative Approach ◽  
High Risk Screening

The Utility of Short-Interval Follow-Up for Baseline High-Risk Screening Breast MRI

2020 ◽  
Vol 71 (2) ◽  
pp. 226-230
Author(s):  
Ravi Shergill ◽  
Heba Osman ◽  
Faten Al-Douri ◽  
Milita Ramonas ◽  
Suad Al Duwaiki ◽  
...  
Keyword(s):  
High Risk ◽  
Short Interval ◽  
Breast Mri ◽  
Risk Screening ◽  
Background Parenchymal Enhancement ◽  
Starting Point ◽  
Screening Study ◽  
Baseline Screening ◽  
High Risk Screening

Objective: Patients with a high lifetime risk of developing breast cancer undergo annual screening magnetic resonance imaging (MRI) starting at age 30. A proportion of these patients are subsequently required to undergo short-interval follow-up MRI 6 months after their baseline examination. The purpose of this study was to evaluate the utility and outcome of these short-interval follow-up examinations in this population. Methods: A retrospective review was performed of 523 patients who received their baseline high-risk breast screening MRI at our institution between 2013 and 2017. The proportion of patients who received a short-interval follow-up MRI at 6 months was recorded. The findings at baseline and follow-up MRI were recorded, as well as the outcomes and results of any interventions performed. Results: Ninety-six (17.6%) patients (age range: 25-67, mean age: 41) received a short-interval follow-up MRI following their baseline screening examination. Indications for follow-up included moderate to marked background parenchymal enhancement, nonmass enhancement, and likely benign enhancing mass. Of the 92 patients, 5 (5.4%) went on to have a biopsy, with none revealing a malignant pathology. The remainder either returned to routine screening (91.3%) or received further imaging in the form of ultrasound or additional follow-up MRI (3.3%). Conclusion: Short-interval follow-up breast MRI in high-risk patients after a baseline screening study with likely benign findings is unlikely to yield clinically significant findings. This retrospective study can be considered a starting point for additional future work looking at the rate, indications, and yield of short-interval follow-up following baseline high-risk screening breast MRI studies.

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