Unveiling breast asymmetries: the diagnostic power of unenhanced and enhanced MRI

Abstract Background Breast asymmetry is a frequent finding on mammography, which could be the result of summing artifacts or normal variation in the breast parenchymal pattern, or it could be a sign of underlying actual pathology. When mammography and breast sonography are unclear or produce inconsistent results, magnetic resonance imaging (MRI) may be utilized to accurately diagnose breast diseases. Objectives To figure out the diagnostic value of both unenhanced and dynamic contrast-enhanced MRI (UEMRI and DCEMRI) in the assessment of cases with mammographically detected breast asymmetries. Methods Fifty-one women with breast asymmetries identified through diagnostic or screening mammography participated in this prospective trial. All patients had UEMRI and DCEMRI, and the reported results were compared either by using the histopathology from suspicious lesions with a score of BIRADS 4 or 5 or by ultrasonography follow-up in benign instances with a score of BIRADS 3. Results The results of UEMRI in correlation to pathology/follow-up data revealed a sensitivity of 100.00%, a specificity of 90.62%, a positive predictive value of 87.5%, a negative predictive value of 100.00%, and an accuracy of 94.3%. DCEMRI showed a sensitivity of 100.00%, a specificity of 81.2%, a positive predictive value of 77.78%, a negative predictive value of 100.00%, and an accuracy of 88.68%. Conclusions The diagnostic performance of the DCEMRI and UEMRI in breast asymmetries showed no significant difference, and hence for assessing breast asymmetry, UEMRI may be regarded as a valid substitute for DCEMRI and a trustworthy diagnostic method, especially in cases where contrast administration can’t be done.