Non-Mass Enhancement on MRI

Management Recommendations ◽

Normal Background ◽

Mass Enhancement ◽

Breast cancer presents on MRI as an enhancing finding on post-contrast T1-weighted images that is distinct from normal background parenchymal enhancement (BPE), and these enhancing lesions can be further described as a focus, mass, or non-mass enhancement (NME). Each enhancing lesion, with the exception of a focus, can be described further with specific morphological features that are defined by the ACR BI-RADS Atlas. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations of a focus of enhancement and non-mass enhancement on MRI. Topics discussed include distinguishing a focus from normal BPE, benign versus suspicious features of a focus, NME characterization, and kinetic enhancement curves.

Mass in Lactating Female

10.1093/med/9780190270261.003.0027 ◽

2018 ◽

Author(s):

Nina Woldenberg ◽

Melissa M. Joines

Keyword(s):

Breast Cancer ◽

Clinical Features ◽

Screening Mammography ◽

Accurate Diagnosis ◽

Comprehensive Understanding ◽

Palpable Mass ◽

Imaging Protocols ◽

Fibrocystic Change ◽

Lactating Breast ◽

Management Recommendations

Timely and accurate diagnosis of a mass in the lactating patient requires comprehensive understanding of the indicated imaging workup. During lactation it is not uncommon for patients to present with a palpable mass that requires evaluation. In patients with a palpable abnormality, diagnostic evaluation should not be delayed due to pregnancy or lactation. In addition, a mass that requires further evaluation may be identified at the time of screening mammography in lactating patients. This chapter, appearing in the section on asymmetry, mass, and distortion, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for a mass in the lactating patient. Topics discussed include differential considerations of benign and malignant masses in the lactating breast including cysts, focal lobular hyperplasia (focal fibrocystic change), galactocele, abscess, fibroadenoma, lactating adenoma, and pregnancy-associated breast cancer.

DCE-MRI Background Parenchymal Enhancement Quantified from an Early versus Delayed Post-contrast Sequence: Association with Breast Cancer Presence

Scientific Reports ◽

10.1038/s41598-017-02341-8 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 7

Author(s):

Shandong Wu ◽

Margarita L. Zuley ◽

Wendie A. Berg ◽

Brenda F. Kurland ◽

Rachel C. Jankowitz ◽

...

Keyword(s):

Breast Cancer ◽

Post Contrast ◽

Dce Mri ◽

Coarse Heterogeneous Calcifications

10.1093/med/9780190270261.003.0038 ◽

2018 ◽

Author(s):

Cheryce Poon Fischer

Keyword(s):

Breast Cancer ◽

Clinical Features ◽

Differential Diagnoses ◽

Intermediate Risk ◽

Imaging Protocols ◽

Prior Surgery ◽

Management Recommendations

Coarse heterogeneous calcifications are irregular calcifications that are between 0.5 mm and 1 mm in size. They are usually in a group and are smaller in size than dystrophic calcifications. Although they are of intermediate risk for breast cancer (most commonly, DCIS), they are also associated with benign entities, such as hyalinized/degenerating fibroadenoma, areas of fibrosis, papilloma, and evolving dystrophic calcifications from prior surgery or trauma. Generally, numerous bilateral groups of coarse heterogeneous calcifications may be considered benign. However, baseline magnification views may be helpful to confirm the morphology of the calcifications and to exclude more suspicious pleomorphic morphology. Coarse heterogeneous calcifications in a linear or segmental distribution are suspicious. This chapter reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnoses, and management recommendations for coarse heterogeneous calcifications.

Breast cancer and background parenchymal enhancement at breast magnetic resonance imaging: a meta-analysis

BMC Medical Imaging ◽

10.1186/s12880-021-00566-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Na Hu ◽

Jinghao Zhao ◽

Yong Li ◽

Quanshui Fu ◽

Linwei Zhao ◽

...

Keyword(s):

Breast Cancer ◽

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Breast Magnetic Resonance Imaging ◽

Meta Analysis ◽

Resonance Imaging ◽

High Background ◽

Breast Magnetic Resonance ◽

Abstract Background The background parenchymal enhancement at breast magnetic resonance imaging use to predict breast cancer attracts many searchers to draw a possible relationship. However, the results of their relationships were conflicting. This meta-analysis was performed to assess breast cancer frequency associations with background parenchymal enhancement. Methods A systematic literature search up to January 2020 was performed to detect studies recording associations between breast cancer frequency and background parenchymal enhancement. We found thirteen studies including 13,788 women at the start with 4046 breast cancer. We calculated the odds ratio (OR) and the 95% confidence intervals (CIs) between breast cancer frequency and background parenchymal enhancement by the dichotomous technique with a random or fixed-effect model. Results Women with minimal or mild background parenchymal enhancement at breast magnetic resonance imaging did not have any risk of breast cancer compared to control women (OR, 1.20; 95% CI 0.54–2.67). However, high background parenchymal enhancement at breast magnetic resonance imaging (OR, 2.66; 95% CI 1.36–5.19) and moderate (OR, 2.51; 95% CI 1.49–4.21) was associated with a significantly higher rate of breast cancer frequency compared to control women. Conclusions Our meta-analysis showed that the women with high and moderate background parenchymal enhancement at breast magnetic resonance imaging have higher risks, up to 2.66 fold, of breast cancer. We suggest that women with high or moderate background parenchymal enhancement at breast magnetic resonance imaging to be scheduled for more frequent follow-up and screening for breast cancer to avoid any complications.

Amount of fibroglandular tissue FGT and background parenchymal enhancement BPE in relation to breast cancer risk and false positives in a breast MRI screening program

European Radiology ◽

10.1007/s00330-019-06020-2 ◽

2019 ◽

Vol 29 (9) ◽

pp. 4678-4690 ◽

Cited By ~ 5

Author(s):

Suzan Vreemann ◽

Mehmet U. Dalmis ◽

Peter Bult ◽

Nico Karssemeijer ◽

Mireille J. M. Broeders ◽

...

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Screening Program ◽

Breast Mri ◽

False Positives ◽

Fibroglandular Tissue ◽

Association Between Background Parenchymal Enhancement and Pathologic Complete Remission Throughout the Neoadjuvant Chemotherapy in Breast Cancer Patients

Translational Oncology ◽

10.1016/j.tranon.2017.07.005 ◽

2017 ◽

Vol 10 (5) ◽

pp. 786-792 ◽

Cited By ~ 10

Author(s):

Chao You ◽

Weijun Peng ◽

Wenxiang Zhi ◽

Min He ◽

Guangyu Liu ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Complete Remission ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Pathologic Complete Remission ◽

The association between breast cancer risk factors and background parenchymal enhancement at dynamic contrast-enhanced breast MRI

Acta Radiologica ◽

10.1177/0284185120911583 ◽

2020 ◽

Vol 61 (12) ◽

pp. 1600-1607

Author(s):

Roxanna Hellgren ◽

Ariel Saracco ◽

Fredrik Strand ◽

Mikael Eriksson ◽

Ann Sundbom ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Mammographic Density ◽

Breast Mri ◽

Mammographic Breast Density ◽

Cancer Risk Factors ◽

Screening Population ◽

Breast Cancer Risk Factors ◽

Background Background parenchymal enhancement (BPE) of normal tissue at breast magnetic resonance imaging is suggested to be an independent risk factor for breast cancer. Its association with established risk factors for breast cancer is not fully investigated. Purpose To study the association between BPE and risk factors for breast cancer in a healthy, non-high-risk screening population. Material and Methods We measured BPE and mammographic density and used data from self-reported questionnaires in 214 healthy women aged 43–74 years. We estimated odds ratios for the univariable association between BPE and risk factors. We then fitted an adjusted model using logistic regression to evaluate associations between BPE (high vs. low) and risk factors, including mammographic breast density. Results The majority of women had low BPE (84%). In a multivariable model, we found statistically significant associations between BPE and age ( P = 0.002) and BMI ( P = 0.03). We did find a significant association between systemic progesterone medication and BPE, but due to small numbers, the results should be interpreted with caution. The adjusted odds ratio for high BPE was 3.1 among women with density D (compared to B) and 2.1 for density C (compared to B). However, the association between high BPE and density was not statistically significant. We did not find statistically significant associations with any other risk factors. Conclusion Our study confirmed the known association of BPE with age and BMI. Although our results show a higher likelihood for high BPE with increasing levels of mammographic density, the association was not statistically significant.