ARRS 2019: BI-RADS 3 Lesions Identified on High-Risk Screening Breast MRI
Posted: Monday, May 20, 2019
At the 2019 American Roentgen Ray Society (ARRS) Annual Meeting in Honolulu, Constance D. Lehman, MD, PhD, Director of Breast Imaging at the Massachusetts General Hospital (MGH), and colleagues reported that Bi-RADS 3 assessments are more common in baseline than nonbaseline screening breast magnetic resonance imaging (MRI) exams (Abstract 2367). They also noted that BI-RADS 3 lesions on baseline exams have a lower cancer yield.
“Many patients and providers question the utility of BI-RADS 3 in MRI… This study clarifies that short-interval follow-up MRI is a valuable method of identifying early-stage breast cancer while avoiding unnecessary biopsies,” noted coauthor Christine Edmonds, MD, of MGH, in an ARRS press release.
A total of 3,214 patients were included in the study, and 6,672 MRI screening exams were performed. More than 200 patients (3.2%) were assigned a BI-RADS (Breast Imaging Reporting and Data System) 3. Among the baseline exams 8% were assigned BI-RAD 3 compared with 2.4% of the nonbaseline exams.
Of the total BI-RAD 3 lesions, 5.4% were malignant, with 11 of the 12 cancers were either stage 0 or I at diagnosis. The cancer yield of BI-RADS 3 was 2.4% on baseline exams compared with 7.2% on nonbaseline exams. Of the 12 diagnosed cancers, 7 were characterized as foci, 3 as nonmass encasements, and 2 as masses. Before the 6-month follow-up, 9 of the 12 tumors were upgraded.
BI-RAD 3 assessments were found to be more common in baseline versus nonbaseline screenings with breast MRI exams. On baseline, the BI-RAD 3 lesions also had a lower cancer yield, as most cancers are diagnosed at or before the 6-month follow-up. When used sensibly, the authors noted, short-interval follow-up MRI seems to be a fitting technique to identify early-stage breast cancer.
Disclosure: The study authors reported no conflicts of interest.