Breast lesions found incidentally on abdominal MRI shown cancerous at a considerable rate

Breast lesions seldom turn up incidentally in abdominal MRI scans. However, when they do, quite a few turn out to be malignant. Accordingly, radiologists interpreting women’s abdominal MRIs should be on the lookout for breast abnormalities.

Vinay Prabhu, MD, MS, and colleagues at NYU make this observation and recommendation in a study published online Nov. 3 in the American Journal of Roentgenology.

Prabhu and team reviewed MRI reports on 11,462 women who were imaged for abdominal diagnoses at NYU’s Langone Medical Center over a seven-year period ending in 2014.

They found that incidental breast lesions were described in the MRI reports of 3 percent of these patients (n = 292). Breast imaging was recommended for 66 percent (n = 192).

Of 63 patients who received their follow-up breast imaging at Langone, 21 (33 percent) underwent biopsy or surgery.

The team found the frequency of incidental breast cancer was only 3 percent of all patients with reported breast lesions and just 0.09 percent of all patients who had abdominal MRI exams—but an eye-opening 11 percent (seven of 63) of the patients who received their follow-up breast imaging at Langone.

“Although incidental breast lesions were rarely detected on abdominal MRI, a considerable number of these lesions were found to represent breast cancer, particularly in women undergoing follow-up breast imaging,” the authors conclude. “Therefore, it is important for the interpreting radiologist to carefully evaluate abdominal MRI examinations for the presence of breast abnormalities and to recommend dedicated breast imaging for any such findings that are indeterminate.”