Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) plays an important role in the detection and management of breast lesions and it is currently recommended for breast cancer staging, screening women at high risk of developing breast cancer, evaluation of patients with CUP-Syndrome ("cancer of unknown primary"), assessment of the integrity of breast prosthesis and breast implants, as well as interventional applications such as a guide to perform breast biopsies [1-3]. Although breast MRI is highly sensitive for detection of breast cancer, its specificity remains modest,...

In this study, we included 46 women (mean age 58 ±11 years) with 53 MRI-detected breast lesions who underwent 3T breast MRI from September 2017 to September 2018 at Radiology Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy. MRI-detected breast lesions were those characterized as Breast Imaging Reporting and Data System (BI-RADS) category 3, 4 or 5 [7] with subsequent benign or malignant confirmation (cytologic or histologic examination or benign finding, BI-RADS U2, at II level ultrasound). We excluded from the analysis known malignant...

Nineteen (35.8%) out of 53 breast lesions were malignant (12 of 33 masses and 7 of 17 lesions with non-mass enhancement) (Table 1). Among malignant lesions with mass enhancement, the prevalent histologic subtype was invasive ductal carcinoma (75%), while among lesions with non-mass enhancement the most frequent histotype was invasive lobular carcinoma (42.8%). The median ADC was significantly lower for malignant than for benign lesions (median ADC value of 0.89 × 10−3 mm2/s versus 1.03 × 10−3 mm2/s respectively; p=0.04) (Fig. 1). Stratifying the analysis...

Quantitative diffusion-weighted MRI performed ad 3T shows promise in the differentiation of benign and malignant lesions. ADC measurements may be more useful for discriminating benign versus malignant mass lesions, regardless of lesion size. Quantitative DWI plays a complementary role to Dynamic Contrast-Enhanced sequences, improving breast lesion characterization while preserving sensitivity of breast MRI.

1.Leithner D, Wengert GJ, Helbich TH, Thakur S, Ochoa-Albiztegui RE, Morris EA, Pinker K. Clinical role of breast MRI now and going forward. Clin Radiol. 2018;73:700-714 2.Mann RM, Balleyguier C, Baltzer PA, Bick U, Colin C, Cornford E, Evans A, Fallenberg E, Forrai G, Fuchsjäger MH, Gilbert FJ, Helbich TH, Heywang-Köbrunner SH, Camps-Herrero J, Kuhl CK, Martincich L, Pediconi F, Panizza P, Pina LJ, Pijnappel RM, Pinker-Domenig K, Skaane P, Sardanelli F. Breast MRI: EUSOBI recommendations for women’s information. Eur Radiol. 2015; 25:3669-78 3. Sardanelli...