The diagnostic performance of magnetic resonance imaging (MRI) in the evaluation of breast ultrasound non-mass lesions: A systematic review

Nasrin  Ahmadinejad; Mohammad Hossein  Golezar; Maedeh  Rouzbahani; Sara  Hassanzadeh; Mohsen  Rastkar

doi:10.18502/bccr.v15i1.18730

Nasrin Ahmadinejad Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Hossein Golezar Student Research Committee, Faculty of Medicine, Shahed University, Tehran, Iran
Maedeh Rouzbahani School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Sara Hassanzadeh School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Mohsen Rastkar Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/bccr.v15i1.18730

Keywords: Non-mass lesion (NML), Breast cancer, Magnetic resonance imaging (MRI), Ultrasound (US)

Abstract

Aim: This study aims to conduct a systematic review of the current knowledge re- garding the diagnostic performance of MRI in the investigation of non-mass lesions of the breast.

Method: Up to July 2022, PubMed, Scopus, Web of Science, and Embase were searched comprehensively. All studies examining the diagnostic performance of MRI in non-mass lesions were included except review articles, articles published in a language other than English, and case reports or series of cases. Two independ- ent reviewers performed a literature review and data extraction. A checklist for cross-sectional studies developed by the Joanna Briggs Institute (JBI) was used to assess sources of bias.

Results: The systematic review included two studies. If any enhancement is pres- ent on MRI, most ultrasound NMLs exhibit a non-mass-enhancement. We found that the distribution of non-mass enhancement lesions was primarily segmental and regional. The highest number of malignancies is associated with segmental distributions since 81.8% of the cases with segmental enhancement were ductal carcinomas, specifically DCIS.

Conclusion: Non-mass lesions of the US that do not enhance in MRI have a good prognosis. Breast cancer is very unlikely in these cases, so follow-up is acceptable unless there is a suspicion of malignancy on mammography. In cases where region- al and segmental enhancement of NMLs occurs on CE-MRI, ductal carcinomas may be present, and a pathological examination is warranted.