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Rationale and Objectives To evaluate outcome of magnetic resonance (MR)-detected biopsied breast lesions ≤5 mm by correlating imaging characteristics with pathology. Methods and Materials Institutional review board–approved retrospective review of 565 lesions biopsied with MR guidance between March 2004 and February 2009 found 68 lesions ≤5 mm in 61 patients. Lesions evaluated were those prospectively recommended for biopsy based on clinical setting, suspicious lesion morphology, and kinetics. Two study radiologists, blinded to final pathology, reviewed MR exams recording patient age, exam indication (staging, surveillance, diagnostic, or follow-up), mass location, size, morphology, T2-weighted signal, and kinetics. Chart review provided final pathology. Results Of 68 masses ≤5 mm, 14 (20.6%) were malignant. Of 32 P = .01). No significant difference in proportion of malignancies was found based on age, T2-weighted signal, morphology, or kinetics. Conclusion For MR-detected biopsied masses, the positive predictive value for malignancy of those ≤5 mm was 20.6%. The highest prevalence of cancers was in the same quadrant as a newly diagnosed breast cancer. The decision to biopsy small masses should be based on carefully assessed MR features, and in the context of exam indication, not solely on size. |
