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  • Title: MRI and comparison mammography: a worthy diagnostic alliance for breast microcalcifications?
    Author: Brnic D, Brnic D, Simundic I, Vanjaka Rogosic L, Tadic T.
    Journal: Acta Radiol; 2016 Apr; 57(4):413-21. PubMed ID: 25995311.
    Abstract:
    BACKGROUND: There is a lack of data concerning diagnostic performance of magnetic resonance imaging (MRI) in patients with new or increasing microcalcifications. PURPOSE: To evaluate suspicious microcalcifications by using comparison mammography, MRI, and a combination of both methods. MATERIAL AND METHODS: Our study group consisted of 55 patients with mammographically detected BI-RADS (Breast Imaging Reporting and Data System) 3-5 microcalcifications for whom comparison mammograms were available. All patients underwent breast MRI before SVAB (stereotactic vacuum-assisted biopsy). Diagnostic performances of comparison mammography and MRI were evaluated, as well as the combination of the respective imaging findings. RESULTS: Of the 55 microcalcification cases, 35 showed progression and 20 were stable between interval screenings. The negative predictive value (NPV) of comparison mammography was 100%, whereas the NPV of MRI was 92%. However, the specificity of combination of findings was 97%, significantly higher than the 42% specificity of comparison mammography (P < 0.001). Additionally, the positive predictive value of combination of findings was 93% versus 44% of comparison mammography (P = 0.001). CONCLUSION: A biopsy is recommended when MRI positive lesion corresponding the area of new or increasing mammographic microcalcifications is detected. Patients with stable microcalcifications can continue follow-up mammography, regardless of MRI result.
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