Published online Jul 28, 2022. doi: 10.4329/wjr.v14.i7.229
Peer-review started: February 19, 2022
First decision: April 8, 2022
Revised: April 16, 2022
Accepted: July 6, 2022
Article in press: July 6, 2022
Published online: July 28, 2022
Processing time: 158 Days and 5 Hours
Magnetic resonance imaging (MRI) with multiparametric dynamic contrast plays a critical role in the assessment of breast lesions. Dynamic curves are a critical parameter in determining the benign or malignant nature of lesions. Dynamic curves of type 1 are known to represent benign masses, while dynamic curves of type 3 are known to identify malignant masses. Type 2 dynamic curves have a sensitivity of 42.6% and specificity of 75% for malignancy detection.
To investigate the pathological diagnosis of lesions with type 2 dynamic curves.
We evaluated breast MRI examinations performed between 2020 and 2021 retrospectively and included lesions with type 2 dynamic curves. We included 38 lesions from 33 patients. The lesions were evaluated for their pathological diagnosis and morphological characteristics.
Twenty-six lesions were malignant, while twelve were benign. The most frequently encountered benign lesion (7/12, 58.3%) was sclerosing adenosis, while the most frequently encountered malignant diagnosis was invasive ductal cancer. The presence of a type 2 dynamic curve had a sensitivity of 40.2% and specificity of 73.4% for predicting malignancy. By combining type 2 curves and morphological features, the sensitivity and specificity were increased.
The high rates of malignancy detected histopathologically among patients with type 2 dynamic curves in our study are remarkable. Type 2 dynamic curves can be detected in benign breast masses, especially in sclerosing adenosis cases. Considering morphological features can increase the diagnostic accuracy in cases with type 2 dynamic curves.
Core Tip: Dynamic contrast-enhanced magnetic resonance imaging (MRI) plays a critical role in the evaluation of breast lesions. The sensitivity and specificity of dynamic curves acquired using MRI are variable. While type 1 curves indicate more benign pathologies and type 3 curves indicate more malignant pathologies, there is a significant overlap in type 2 dynamic curves. We examined the histopathological outcomes of lesions with type 2 curves retrospectively. The histopathology results of lesions with type 2 curves were malignant at a rate of 68.4%. The presence of a type 2 dynamic curve had a sensitivity of 40.2% and specificity of 73.4% for predicting malignancy. By combining type 2 curves and morphological features, the area under the curve, sensitivity, and specificity were increased.