New suspicious lesions on breast MRI in neoadjuvant therapy

January 14, 2021

Leesburg, VA, January 14, 2021--According to ARRS' American Journal of Roentgenology (AJR), new suspicious findings occurred in 5.5% of breast MRI examinations performed to monitor response to neoadjuvant therapy; none of these new lesions were malignant.

"Our findings suggest that new lesions that arise in the setting of neoadjuvant therapy are highly unlikely to represent a new site of malignancy, particularly if the index malignancy shows treatment response," wrote Donna A. Eckstein and colleagues in the department of radiology and biomedical imaging at the University of California, San Francisco.

Based on a presentation at the ARRS 2019 Annual Meeting, Honolulu, HI, the researchers' retrospective review pinpointed all breast MRI examinations performed to assess response to neoadjuvant therapy between 2010 and 2018. Cases with new suspicious lesions assessed as BI-RADS 4 or 5 and found after the initiation of neoadjuvant treatment were included. Meanwhile, exclusion criteria were cases with no pretreatment MRI, cases in which the suspicious lesion was present on the baseline MRI but remained suspicious, and cases with insufficient follow-up. Pathologic examination determined malignant outcomes, whereas benignity was established by pathologic examination, follow-up imaging, or both.

A total of 419 breast MRI examinations in 297 women (mean patient age, 45 years; range, 32-65 years) were performed to assess response to neoadjuvant treatment. After exclusions, 23 MRI examinations (5.5%) with new suspicious findings distinct from the site of known malignancy comprised the final study cohort. Of these 23 lesions, 13 new suspicious findings (56.5%) were contralateral to the known malignancy, nine (39.1%) were ipsilateral, and one (4.3%) involved the bilateral breasts. Lesion types included mass (16, 69.6%), nonmass enhancement (5, 21.7%), and focus (2, 8.7%).

Noting that, currently, there are no guidelines for the management of new suspicious imaging findings identified on MRI during the course of neoadjuvant systemic breast cancer treatment, "results in this small cohort suggest that these new findings are highly likely to be benign, particularly in the setting of response to therapy, which may potentially obviate biopsies in these patients in the future," wrote Eckstein et al.

"However," the authors of this AJR article concluded, "larger studies across different facilities are needed to confirm whether biopsy may be safely averted in this scenario."
Press passes are now available for the ARRS 2021 All-Virtual Annual Meeting:

Founded in 1900, the American Roentgen Ray Society (ARRS) is the first and oldest radiological society in North America, dedicated to the advancement of medicine through the profession of radiology and its allied sciences. An international forum for progress in medical imaging since the discovery of the x-ray, ARRS maintains its mission of improving health through a community committed to advancing knowledge and skills with an annual scientific meeting, monthly publication of the peer-reviewed American Journal of Roentgenology (AJR), quarterly issues of InPractice magazine, AJR Live Webinars and Podcasts, topical symposia, print and online educational materials, as well as awarding scholarships via The Roentgen Fund®.

American Roentgen Ray Society

Related MRI Articles from Brightsurf:

Does MRI have an environmental impact?
Researchers from Tokyo Metropolitan University have surveyed the amount of gadolinium found in river water in Tokyo.

MRI predict intelligence levels in children?
A group of researchers from the Skoltech Center for Computational and Data-Intensive Science and Engineering (CDISE) took 4th place in the international MRI-based adolescent intelligence prediction competition.

7T MRI offers new insights into multiple sclerosis
Investigators from Brigham and Women's Hospital have completed a new study using 7 Tesla (7T) MRI -- a far more powerful imaging technology -- to further examine LME in MS patients

Magnetic eyelashes: A new source of MRI artifacts
American Journal of Roentgenology researchers used a phantom to show that magnetic eyelashes worn during MRI can cause substantial artifact and that detachment of the eyelashes from the phantom can occur.

High-strength MRI tracks MS progression
The development of scars, or lesions, in the brain's cortical gray matter is a powerful predictor of neurological disability for people with multiple sclerosis (MS), according to new study.

Non-contrast MRI is effective in monitoring MS patients
Brain MRI without contrast agent is just as effective as the contrast-enhanced approach for monitoring disease progression in patients with multiple sclerosis (MS), according to a new study.

Researchers use MRI to predict Alzheimer's disease
MRI brain scans perform better than common clinical tests at predicting which people will go on to develop Alzheimer's disease, according to a new study.

Monitoring electromagnetic signals in the brain with MRI
MIT engineers have devised a new technique to detect either electrical activity or optical signals in the brain, using a minimally invasive technique based on magnetic resonance imaging (MRI).

MRI 'glove' provides new look at hand anatomy
A new kind of MRI component in the shape of a glove delivers the first clear images of bones, tendons and ligaments moving together.

Why we need erasable MRI scans
Gas-filled protein structures could one day be used as 'erasable' contrast agents for MRI scans.

Read More: MRI News and MRI Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to