False-positive Extra-Mammary Findings in Breast MRI: Another Cause for Concern

Breast J. 2016 Jan-Feb;22(1):90-5. doi: 10.1111/tbj.12524. Epub 2015 Oct 28.

Abstract

Breast magnetic resonance imaging (MRI) has been repeatedly shown to have a high false-positive rate for additional findings in the breast resulting in additional breast imaging and biopsies. We hypothesize that breast MRI is also associated with a high rate of false-positive findings outside of the breast requiring additional evaluation, interventions, and delays in treatment. We performed a retrospective review of all breast MRIs performed on breast cancer patients in 2010 at a single institution. MRI reports were analyzed for extra-mammary findings. The timing and yield of the additional procedures was also analyzed. Three hundred and twenty-seven breast cancer patients (average age = 53.53 ± 11.08 years) had a breast MRI. Incidental, extra-mammary findings were reported in 35/327 patients (10.7%) with a total of 38 incidental findings. The extra-mammary findings were located in the liver (n = 21, 60.0%), thoracic cavity (n = 12, 34.3%), kidneys (n = 1, 2.9%), musculoskeletal system (n = 3, 8.6%), and neck (n = 1, 2.9%). Eighteen of the 35 patients (51.4%) received additional radiographic imaging, 3 (8.6%) received additional laboratory testing, 2 (5.7%) received additional physician referrals and 2 (5.7%) received a biopsy of the finding. The average time to additional procedures in these patients was 14.5 days. None of the incidental, extra-mammary findings were associated with breast cancer or other malignancy. Breast MRI was associated with a high rate (10.7%) of extra-mammary findings, which led to costly additional imaging studies, referrals, and tests. These findings were not associated with breast cancer or other malignancies. Extra-mammary findings highlight an unrecognized adverse consequence of breast MRI.

Keywords: MRI; cost; delay; extra-mammary; incidental.

MeSH terms

  • Adult
  • Breast Neoplasms / pathology*
  • False Positive Reactions
  • Female
  • Humans
  • Incidental Findings*
  • Kidney / diagnostic imaging
  • Kidney / pathology
  • Liver / diagnostic imaging
  • Liver / pathology
  • Magnetic Resonance Imaging / methods*
  • Medicare
  • Middle Aged
  • Neck / diagnostic imaging
  • Neck / pathology
  • Radiography / economics
  • Retrospective Studies
  • United States