Is there any Correlation between Magnetic Resonance Imaging Features of Breast Lesions of BIRADS Category 4 with Histopathologic Results?

To evaluate the correlation of magnetic resonance imaging (MRI) features of breast lesions of Breast Imaging Reporting and Database System (BI‑RADS) category 4 with histopathologic results.

In a prospective study between December 2013 and April 2015, patients with suspicious mammographic and/or ultrasound findings referred for Breast MRI were evaluated. Patients with lesions of BI‑RADS category 4 were enrolled with a written informed consent. In each patient, mass lesion (ML) or nonmass lesion (NML) was determined, and different characteristics of the lesions were recorded. A follow‑up program was taken with mean 3–12 months. Patients who underwent core needle biopsy or open biopsy were summoned.

Seventy‑eight females aged 24–67 years (mean 43.1 ± 8.8) met the inclusion criteria and had adequate samples for histopathologic study. Twenty‑nine (37.2%) patients had ML and 49 (62.8%) patients had NML. Tissue sampling in 63 (80.7%) patients was through core needle biopsy and in 15 (19.2%) patients through surgery. A wide spectrum of benign and malignant pathologic diagnoses was seen. In statistical analysis, none of the MRI features has a significant correlation with any specific histopathologic diagnosis (P = 0.185). However, the relation between the MRI category (ML or NML) and pathology results was significant at level of 0.1 (P = 0.06).

This study showed that a wide spectrum of histopathologic results is seen in BI‑RADS category 4. However, in this sample volume, none of the MRI features in this BI‑RADS category has a significant correlation with any specific histopathologic diagnosis.