PPV3 of suspicious breast mri findings

Rationale and Objectives: Magnetic resonance imaging (MRI) characteristics of Breast Imaging Reporting and Data System (BI-RADS) 4 and 5 lesions were evaluated to identify characteristics that may improve the positive predictive value (PPV) of a biopsy. Materials and Methods: MRI BI-RADS 4 or 5 breast findings in 101 women who underwent biopsy leading to a diagnosis of cancer within 1 year (PPV3; n=115 cases) were reviewed. Patient history, lesion morphology, enhancement pattern and kinetics, and T2 characteristics were examined. Results: The PPV3 of all BI-RADS 4 and 5 breast lesions seen on MRI was 22.6% (26 of 115). Excluding lesions with second-look imaging correlates decreased the PPV3 to 11.8% (6/51). Of the MRI-guided biopsies, 20.9% (24 of 115) yielded a high-risk lesion, altering surgical management. MRI lesion type did not significantly affect the PPV3: the PPV3 was 26.3% (15 of 57) for masses, 21.4% (9 of 42) for non mass enhancement (NME) and 12.5% (2 of 16) for suspicious foci. The PPV3 for lesions found on diagnostic MRI in women with newly diagnosed cancer was 30.8% (20 of 65) which was statistically significantly greater compared to a PPV3 of 11.9% (5 of 42) for lesions identified on high-risk screening MRI. Conclusions: Suspicious MRI findings identified on a second-look examination are more likely malignant than those seen only on MRI. Suspicious MRI findings discovered in patients with concurrent malignancy have a greater PPV3 than those detected on high-risk screening MRIs. However, the type of MRI finding (mass vs. NME vs. foci) does not significantly affect the PPV3 and should not be used as a discriminator for determining biopsy threshold.



Work Title PPV3 of suspicious breast mri findings
Open Access
  1. Haydan Smith
  2. Alison L. Chetlen
  3. Susann Schetter
  4. Julie Mack
  5. Meredith Watts
  6. Junjia Jay Zhu
License In Copyright (Rights Reserved)
Work Type Article
  1. Academic Radiology
Publication Date December 1, 2014
Publisher Identifier (DOI)
  1. https://doi.org/10.1016/j.acra.2014.07.013
Deposited July 09, 2021




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  • Added PPV3_Breast_MRI_findings.pdf
  • Added Creator Haydan Smith
  • Added Creator Alison L. Chetlen
  • Added Creator Susann Schetter
  • Added Creator Julie Mack
  • Added Creator Meredith Watts
  • Added Creator Junjia Jay Zhu
  • Published
  • Updated Work Title Show Changes
    Work Title
    • PPV<sub>3</sub> of suspicious breast mri findings
    • PPV3 of suspicious breast mri findings
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