Application of abbreviated protocol of magnetic resonance imaging for breast cancer screening in dense breast tissue

Objective To evaluate the application of abbreviated protocol (AP) of magnetic resonance imaging (MRI) in screening of breast cancer with dense breast tissue. Methods Total 478 patients with dense breast tissue, who had negative X-ray mammography (MG), underwent dynamic contrast-enhanced MRI (DCE-MRI). The AP MRI, which consisted of first postcontrast subtracted (FAST) and maximum-intensity projection (MIP), and full diagnostic protocol (FDP) MRI images were analyzed by Breast Imaging Reporting and Data System (BI-RADS). Among 478 patients the histopathological diagnosis was available in 39 cases (41 breast lesions) . With pathological diagnosis as gold standard, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of AP and FDP in breast cancer detection were evaluated. Results In 41 breast lesions there were 16 malignant lesions and 25 benign lesions. FDP detected all 16 malignant lesions, including 9 cases of ductal carcinoma in situ, 6 cases of invasive ductal carcinoma and 1 case of mucinous carcinoma; AP detected 15 out of 16 cases of breast cancer. The sensitivity of FDP and AP in detection of breast malignant lesions was 16/16 and 15/16, respectively (χ2=0.725, P=0.224). The specificity of FDP and AP was 92%(23/25) and 76%(19/25), respectively (χ2=6.327, P=0.012). Conclusion For women with dense breast tissue AP of MRI can be used in early screening of breast cancer. Key words: Breast screening; Magnetic resonance imaging; First postcontrast subtracted; Maximum-intensity projection