Role of Diffusion Weighted MRI in Diagnosis of Breast Masses (BIRADS III and BIRADS IV)

Abstract

owadays sonomammography still represents the primary imaging modality utilized for breast cancer screening and diagnosis. Nonetheless, even when correctly performed, mammography has an important limitation suffering from a lack of specificity but provides a high sensitivity in fatty breasts. Limitations of this procedure arise from different sources: poor technique, observer error, and the size and nature of the breast lesions, particularly in dense breasts. These limits have provoked the progressive diffusion of magnetic resonance imaging (MRI) as a powerful tool for the depiction and diagnosis of various breast masses, and further staging of breast cancer Breast MRI has become an important adjunct modality in the evaluation of suspicious mammographically occult breast lesions, detection of tumor recurrence, and screening of women with high-risk cancer. Despite its superb advantages, an overlap between the MRI findings of benign and malignant lesions still exists, resulting in variable specificity which may be attributable to the false positives related to the menstrual cycle, hormonal therapy, proliferative alterations, fibroadenomas, and papillomas. Because of this confounding overlap, in some cases it is not possible to make the differential diagnosis between benign and malignant lesions on the basis of conventional MRI features.