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Purpose: This study aims to investigate sensitivity of breast magnetic resonance imaging (MRI) for mammographic microcalcifications-only ductal carcinoma in situ (DCIS), based on its histopathology and mammographic extent of microcalcifications., Methods: Mammograms were reviewed to measure the extent of microcalcifications. Sensitivity of MRI was calculated in the overall study population and in groups differing for DCIS nuclear grade, microinvasivity, and microcalcifications' extent., Results: Overall sensitivity of MRI was 78.3% for dynamic contrast enhanced and 66.7% for diffusion-weighted imaging and did not vary with nuclear grade and microinvasivity, while it increased with larger extent of microcalcifications (ExpB=1.063-1.046, P=.037-.013)., Conclusions: Mammographic extent of microcalcifications positively affects sensitivity of breast MRI., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: To describe magnetic resonance imaging (MRI) findings in patients who underwent breast-conserving surgery followed by oxidized regenerated cellulose (ORC) implantation in surgical cavity., Materials and Methods: We retrospectively reviewed 51 MRI examinations performed between January 2009 and January 2014 in 51 patients who underwent BCS with ORC implantation., Results: In 29/51 (57 %) cases, MRIs showed abnormal findings with three main MRI patterns: (1) complex masses: hyperintense collections on T2-weighted (w) images with internal round hypointense nodules without contrast enhancement (55 %); (2) completely hyperintense collections (17 %); and (3) completely hypointense lesions (28 %). All lesions showed rim enhancement on T1w images obtained in the late phase of the dynamic study with a type 1 curve. Diffusion-weighted imaging was negative in all MRIs and, in particular, 22/29 (76 %) lesions were hyperintense but showing ADC values >1.4 × 10(-3) mm(2)/s, while the remaining 7/29 (24 %) lesions were hypointense. In four cases, linear non-mass-like enhancement was detected at the periphery of surgical cavity; these patients were addressed to a short-term follow-up, and the subsequent examinations showed the resolution of these findings., Conclusion: When applied to surgical residual cavity, ORC can lead alterations in surgical scar. This could induce radiologists to misinterpret ultrasonographic and mammographic findings, addressing patients to MRI or biopsy; so knowledge of MRI specific features of ORC, it is essential to avoid misdiagnosis of recurrence.

Objectives: Incidental extra-mammary findings in breast Magnetic Resonance Imaging (MRI) may be benign in nature, but may also represent a metastasis or another important lesion. We aimed to analyse the prevalence and clinical relevance of these unexpected findings., Methods: A retrospective review of 1535 breast MRIs was conducted. Only axial sequences were reassessed. Confirmation examinations were obtained in all cases., Results: 285 patients had a confirmed incidental finding, which were located in the liver (51.9%), lung (11.2%), bone (7%), mediastinal lymph nodes (4.2%) or consisted of pleural/pericardial effusion (15.4%). 20.4% of incidental findings were confirmed to be malignant. Positive predictive value for MRI to detect a metastatic lesion was high if located within the bone (89%), lymph nodes (83%) and lung (59%), while it was low if located within the liver (9%) or if it consisted of pleural/pericardial effusion (6%). The axial enhanced sequence showed superior sensitivity to unenhanced images in detecting metastatic lesions, especially if only smaller (≤10 mm.) lesions were considered., Conclusions: The prevalence of metastatic incidental extra-mammary findings is not negligible. Particular attention should be to incidental findings located within the lung, bone and mediastinal lymph nodes.

A case of diabetic mastopathy studied with MR-mammography is described. It concerns a female patient with long-lasting (10-years) insulin-dependent diabetes mellitus. A non-tender, palpable firm-to hard mass of the left breast was found and studied with mammography, ultrasonography and MR-mammography. Surgical excision of the mass was performed. The mammogram revealed dense fibroglandular tissue bilaterally. Ultrasonography showed hypoechoic solid tissue in the region of palpable breast mass with marked posterior acoustic shadowing. MR-mammography showed a hypointense area of fibrosis with poor enhancement. Quantitative analysis revealed a typically benign gradual type dynamic curve. MR-mammography can be useful to differentiate diabetic mastopathy from malignant lesions. In women with diabetic mastopathy MR-mammography, clinical examination and careful follow-up may prevent surgical excision.

The role of MRI in the evaluation of breast implants, based on the observations collected over a 2-year period at the "Istituto di Radiologia" of the "Università Cattolica del S. Cuore" of Rome, is reported. In women with breast implants both mammography and sonography have a lower diagnostic accuracy in the evaluation of the glandular parenchyma. At present, MRI plays a primary role in patients with breast implants for the diagnosis of rupture. Based on the international literature its sensitivity is 90-95% and the specificity is 95-100%. Therefore, it can be considered the gold standard procedure in the diagnosis of locoregional recurrence. In spite of the excellent sensitivity and specificity of MRI in the evaluation of patients with breast implants, the integration with information from clinical examinations and conventional imaging is required together with an exhaustive knowledge of this method whose development is still in progress.

The study was carried out to evaluate the response to preoperative chemotherapy of locally advanced breast cancer with MRI. The series included 45 women with locally advanced breast cancer who underwent MRI before and after neoadjuvant chemotherapy. Based on the volume of residual disease, the response to chemotherapy was classified as: complete response, partial response, minor response, no change and disease progression. Responses to neoadjuvant chemotherapy were compared to MRI findings and to prognostic factors. Based on MRI findings 8 patients were assigned to the complete response group, 16 to the partial response group, 11 to the minor response group, 9 to the no change group and 1 patient to the disease progression group. MRI showed 90.2% sensitivity, 100% specificity and 91.1% accuracy. The correlation between MRI findings and prognostic factors may be useful to predict cancer aggressiveness and to understand the natural history of different breast carcinomas.

The study was carried out to assess the role of magnetic resonance imaging in the inflammatory carcinoma of the breast. 15 female patients with a clinical diffuse inflammatory process in the breast underwent mammography, sonography and dynamic magnetic resonance imaging. All inflammatory carcinomas showed a patch enhancement pattern and in 7/10 there were some areas of focal enhancement. A patch enhancement was observed in 2/5 cases of mastitis while in the other 3 cases nodular focal areas with peripheral enhancement were seen. The dynamic curves were always of wash-out type. Maximum signal intensity value was over 70% in 3/5 cases of mastitis and in 9/10 cases of inflammatory carcinoma. Our results suggest that the role of magnetic resonance imaging in the characterization of inflammatory processes of the breast is nonspecific, while it may be useful in the follow-up of mastitis.

The sensitivity, specificity and accuracy of MRI in detecting breast cancer recurrence were analyzed. 40 patients undergoing breast conserving therapy were studied with MRI. Cytohistologic examinations of suspected local recurrence were carried out. In these patients, the clinical, mammographic and sonographic characteristics of local recurrence were nonspecific or dubious. All patients were examined at least 1 year after completion of radiation therapy. Qualitative and quantitative information was acquired with dynamic MRI. Statistical analysis was performed with the Student's t test. Breast cancer recurrence identified in 22 patients was confirmed on histology in all of them. There were only 2 cases of false positive results. MRI showed 95% accuracy, 100% sensitivity and 88.8% specificity with 5% false-positives and 100% negative predictive value. Dynamic MRI appears a valuable technique for differentiation of post-treatment changes in recurrent carcinoma and for guiding the histological confirmation.

Purpose: To determine the sensitivity, specificity and accuracy of magnetic resonance imaging (MRI) in detecting breast cancer recurrence., Materials and Methods: Forty women conservatively treated for breast cancer underwent MRI and confirmation on histology and cytology of suspected local recurrence. In these patients both clinical and mammographic/ultrasound features of local recurrence were nonspecific or suspicious. All patients were examined at least 1 year after completion of radiation treatment. Dynamic magnetic resonance imaging was performed with a 1.5 T unit using a dedicated bilateral breast coil. Qualitative and quantitative data were obtained. Statistical analysis was also performed with the Student T-test., Results: Breast cancer recurrence was confirmed on histology in 22 patients. MRI identified all the 22 breast recurrent cancers. False-positive contrast enhancement was seen in only two patients. In four patients recurrence was classified as multifocal. In one patient the tumor was detected in the contralateral breast. MRI showed 95% accuracy, 100% sensitivity, 88.8% specificity with 5% false-positives and 100% negative predictive value., Conclusion: Dynamic MRI appears a valuable technique for differentiation of post-treatment changes from recurrent carcinoma and for guiding the histological confirmation. Its high negative predictive value may have an impact on follow-up of treated breast.