Breast Cancers Not Detected at MRI: Review of False-Negative Lesions

Breast Cancers Not Detected at MRI: Review of False-Negative Lesions
Akiko Shimauchi, Sanaz A. Jansen, Hiroyuki Abe, Nora Jaskowiak, Robert A. Schmidt, and Gillian M. Newstead
AJR 2010;194:1674-1679

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RESULTS. Enhancement was observed in 213 (95.9%) of the 222 cancer lesions. Of the nine lesions without visible enhancement, two lesions were excluded because the entire tumor had been excised at percutaneous biopsy performed before the MRI examination and no residual tumor was noted on the final histology. The overall sensitivity of MRI for the known cancers was 96.8% (213/220); for invasive cancer, 98.3% (176/179); and for ductal carcinoma in situ, 90.2% (37/41).

CONCLUSION. In a population of 220 sequentially diagnosed breast cancer lesions, we found seven (3.2%) MRI-occult cancers, fewer than seen in other published studies. Small tumor size and diffuse parenchymal enhancement were the principal reasons for these false-negative results. Although the overall sensitivity of cancer detection was high (96.8%), it should be emphasized that a negative MRI should not influence the management of a lesion that appears to be of concern on physical examination or on other imaging techniques