Gutierrez Robert L, Demartini Wendy B, Eby Peter, Kurland Brenda F, Peacock Sue, Lehman Constance D
Department of Radiology, University of Washington Medical Center, University of Washington, Seattle, WA, USA.
Acad Radiol. 2009 Oct;16(10):1281-5. doi: 10.1016/j.acra.2009.04.012.
To evaluate the associations of patient age and clinical indication with the risk of malignancy for suspicious lesions initially detected on breast magnetic resonance imaging (MRI).
After institutional review board approval, a retrospective review of our breast MRI database was performed to identify all nonpalpable, mammographically occult, MRI-detected suspicious lesions between January 1, 2003, and November 30, 2006, that underwent needle or excisional biopsy. Clinical indication and patient age were recorded and their associations with risk of malignancy were assessed using univariate and multivariate generalized estimating equations.
The likelihood of malignancy was significantly higher (P = .0004) for suspicious lesions found on MRI examinations performed for a patient history of known cancer/evaluate extent of disease (130/309, 42%) compared to lesions identified on examinations conducted for high-risk screening (21/96, 22%). Suspicious lesions found in patients > or = 50 years of age were also more likely to be malignant (92/209, 44%) compared to those found in patients <50 years of age (59/196, 30%) (P = .004). In a multivariable model, both clinical indication of known cancer (OR 2.39, 95% CI 1.33-4.30) and age of 50 years or older (OR 1.66, 95% CI 1.03-2.68) were independently associated with greater risk of malignancy.
The clinical indication of known cancer/evaluate extent of disease and patient age of 50 years or older significantly increase the risk of malignancy in suspicious MRI-detected lesions.
评估患者年龄和临床指征与乳腺磁共振成像（MRI）最初检测出的可疑病变的恶性肿瘤风险之间的关联。
经机构审查委员会批准后，对我们的乳腺MRI数据库进行回顾性研究，以识别2003年1月1日至2006年11月30日期间所有不可触及、乳腺X线摄影未发现、MRI检测出的可疑病变，这些病变均接受了穿刺活检或切除活检。记录临床指征和患者年龄，并使用单变量和多变量广义估计方程评估它们与恶性肿瘤风险的关联。
与因高危筛查进行的MRI检查中发现的病变（21/96，22%）相比，因已知癌症病史/评估疾病范围进行的MRI检查中发现的可疑病变的恶性可能性显著更高（P = 0.0004）（130/309，42%）。与年龄<50岁的患者中发现的可疑病变（59/196，30%）相比，年龄≥50岁的患者中发现的可疑病变也更有可能是恶性的（92/209，44%）（P = 0.004）。在多变量模型中，已知癌症的临床指征（OR 2.39，95%CI 1.33 - 4.30）和50岁及以上的年龄（OR 1.66，95%CI 1.03 - 2.68）均与更高的恶性肿瘤风险独立相关。
已知癌症/评估疾病范围的临床指征以及50岁及以上的患者年龄显著增加了MRI检测出的可疑病变的恶性肿瘤风险。
