Which is more sensitive: breast MRI or whole-breast ultrasound?

Wednesday, December 2 | 10:30 a.m.-10:40 a.m. | SSK02-01 | Room E450A
Which is more sensitive for localizing breast cancer in patients already diagnosed: bilateral whole-breast ultrasound or breast MRI? Which is more specific? Researchers from MD Anderson Cancer Center will address these questions during this Wednesday morning session.

For their study, Dr. Hongying He, PhD, and colleagues included 259 patients who had been diagnosed with breast cancer between January 2011 and August 2014. All patients underwent mammography, bilateral whole-breast ultrasound, and MRI before surgery.

The group used histopathology of lesions to determine the incremental cancer detection rates of bilateral whole-breast ultrasound and breast MRI, and to calculate the sensitivity, specificity, positive predictive value, and negative predictive value of these two modalities and also mammography.

In 259 women, 539 lesions were identified on at least one modality. Of these, 393 were malignant (73%) and 146 were benign (27%). MRI had the highest sensitivity and mammography had the lowest, but MRI had the lowest specificity and mammography had the highest.

Based on the results, He and colleagues concluded that breast MRI is more sensitive than bilateral whole-breast ultrasound and mammography, and mammography and bilateral whole-breast ultrasound are more specific than MRI. In addition, adding ultrasound or MRI to mammography improved the detection of multifocal, multicentric, and contralateral disease, compared with mammography alone.

These mixed findings suggest that the role of MRI in breast cancer detection and management needs further clarification, according to the researchers.

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