Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics.

Abstract:

OBJECTIVES:To predict the probability of malignancy for MRI-detected breast lesions with a multivariate model incorporating patient and lesion characteristics. METHODS:Retrospective review of 2565 breast MR examinations from 1/03-11/06. BI-RADS 3, 4 and 5 lesions initially detected on MRI for new cancer or high-risk screening were included and outcomes determined by imaging, biopsy or tumor registry linkage. Variables were indication for MRI, age, lesion size, BI-RADS lesion type and kinetics. Associations with malignancy were assessed using generalized estimating equations and lesion probabilities of malignancy were calculated. RESULTS:855 lesions (155 malignant, 700 benign) were included. Strongest associations with malignancy were for kinetics (washout versus persistent; OR 4.2, 95% CI 2.5-7.1) and clinical indication (new cancer versus high-risk screening; OR 3.0, 95% CI 1.7-5.1). Also significant were age > = 50 years, size > = 10 mm and lesion-type mass. The most predictive model (AUC 0.70) incorporated indication, size and kinetics. The highest probability of malignancy (41.1%) was for lesions on MRI for new cancer, > = 10 mm with washout. The lowest (1.2%) was for lesions on high-risk screening, <10 mm with persistent kinetics. CONCLUSIONS:A multivariate model shows promise as a decision support tool in predicting malignancy for MRI-detected breast lesions.

journal_name

Eur Radiol

journal_title

European radiology

authors

Demartini WB,Kurland BF,Gutierrez RL,Blackmore CC,Peacock S,Lehman CD

doi

10.1007/s00330-011-2094-6

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

1609-17

issue

8

eissn

0938-7994

issn

1432-1084

journal_volume

21

pub_type

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