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Purpose: To determine the frequency, malignancy rate, and imaging characteristics of BI-RADS (Breast Imaging Reporting and Data System) 3 MRI detected lesions., Materials and Methods: A total of 4370 consecutive contrast-enhanced breast MRI exams from March 1, 2004, to March 1, 2009, were retrospectively reviewed. The study was HIPAA (Health Insurance Portability Accountability Act) compliant and Institutional Review Board approved. The frequency of BI-RADS 3 MRI interpretations and lesion type, as well as malignancy rate at follow-up were calculated., Results: There were 348/4370 (8%) BI-RADS 3 exams performed on 345 patients. There were 125 foci (35.9%), 52 non-masslike enhancements (14.9%), and 171 masses (49.1%). There were 207 lesions with biopsy or imaging follow-up of at least 24 months (mean, 32 months; range, 6-77 months) of the BI-RADS 3 lesion. Five of these 207 (2.4%) lesions were found to be malignant., Conclusion: Rate of malignancy among BI-RADS 3 MRI exams with follow-up was 2.4%. Types of lesions assigned as probably benign were 35.9% foci, 14.9% non-masslike enhancements, and 49.1% masses., (Copyright © 2013 Wiley Periodicals, Inc.)

Objectives: The purpose of this study was to determine the utility of targeted sonography in the management of probably benign breast lesions detected on magnetic resonance imaging (MRI)., Methods: A total of 4370 consecutive contrast-enhanced breast MRI examinations from March 1, 2004, to March 1, 2009, were retrospectively reviewed. The study was Health Insurance Portability and Accountability Act compliant and Institutional Review Board approved. When targeted sonography was recommended for a Breast Imaging Reporting and Data System (BI-RADS) category 3 examination, results of the sonography and any subsequent breast pathologic examinations were recorded. The frequency of identifying the MRI-detected lesions and the rate at which the BI-RADS category was changed by sonography were calculated for mass and non-mass-like lesions., Results: Of the 4370 examinations, 349 (8%) had BI-RADS 3 findings in 346 patients. One hundred eighteen lesions underwent targeted sonography for evaluation of 85 masses and 33 areas of non-mass-like enhancement. Of these 118 lesions, 54 (46%) were seen on sonography. No cancers were detected on sonography in the areas of non-mass-like enhancement. Two of the 85 masses (2.4%) evaluated with targeted sonography had a malignant diagnosis before initiation of follow-up., Conclusions: Selective use of targeted sonography, particularly in masses, may help identify some malignancies before initiating short-interval follow-up for MRI-detected BI-RADS 3 lesions.

Purpose: To determine whether baseline screening breast magnetic resonance (MR) imaging studies have a higher rate of follow-up or biopsy recommendation than do studies with prior MR images available for comparison., Materials and Methods: This was an institutional review board-approved, HIPAA-compliant, retrospective study. Informed consent was waived. Reports from 650 consecutive screening breast MR imaging examinations performed in women between September 2007 and December 2008 were reviewed. All examinations were performed by using the same protocol, and images were interpreted by the same radiologists. Presence of comparison studies, Breast Imaging Reporting and Data System (BI-RADS) category, and biopsy results were recorded. Data were analyzed by using the χ(2) test, the two-sample test of proportions, and the Fisher exact test., Results: Mean patient age was 51 years (range, 25-81 years). Of the baseline studies, findings in 31 of 307 (10.1%) were interpreted as BI-RADS category 3 and findings in 18 of 307 (5.9%) were interpreted as BI-RADS category 4 or 5. Of the examinations with findings classified as BI-RADS category 4 or 5, the results in two of 18 (11.1%) were positive for malignancy at biopsy. Of the examinations with prior MR images for comparison, findings in nine of 343 (2.6%) were interpreted as BI-RADS category 3 and findings in 16 of 343 (4.7%) were interpreted as BI-RADS category 4 or 5. Of the examinations with findings classified as BI-RADS category 4 or 5, the results in three of 16 (18.8%) were positive for malignancy at biopsy. The difference in the number of BI-RADS category 3 interpretations between the two groups was significant (P < .001), but there was no significant difference in BI-RADS category 4 or 5 interpretations or positive predictive values., Conclusion: Baseline screening MR imaging was associated with a higher likelihood of recommendation for short-interval follow-up than was MR imaging with prior images for comparison., (© RSNA, 2011.)