Additional Imaging For Extramammary Findings on Breast MR

Additional imaging evaluation for E3 and E4 extramammary findings from breast MRIs can help physicians identify clinically important disease without adding significant costs, according to a study published in the journal Radiology.

Researchers from Harvard Medical School and Massachusetts General Hospital in Boston sought to evaluate the frequency of extramammary findings on MR images of the breast and how they affected patient outcome and healthcare expenditures.

A total of 2,324 breast MRIs, performed between January 1, 2010 and December 31, 2010, were reviewed. The researchers were looking for extramammary findings, categorized by using CT colonography reporting and data system (C-RADS). Reviewers assessed each patient who had been classified as category E3 or E4, for clinical relevance and pathologic outcome. The researchers also looked at the cost of additional imaging.

“Extramammary findings were identified in 391 of 2,324 breast MR examinations (16.8%), which included 105 patients (4.5%) with E3 or E4 findings,” the authors wrote.  Eighty-six (3.7%) of the 2,324 patients had recommendations for further imaging. Among these patients, nine (0.4%) were found to have a clinically important finding. The most common indication for further imaging was hepatic lesions. “Abdominal MR examinations accounted for 55 percent of costs related to additional imaging. Averaged across the entire cohort, further imaging evaluation and follow-up of incidental findings contributed an additional $16 to each breast MR imaging performed.”

The authors concluded that the use of extra imaging for patients with E3 and E4 extramammary findings could result in identification of clinically important disease, without adding too much to overall cost.