Ultrasound diagnosis Magnetic resonance imaging (MRI) has become an essential diagnostic tool for detecting breast lesions, particularly when conventional imaging modalities like mammography and ultrasound fail to identify certain abnormalities. MRI is highly sensitive, which allows it to detect lesions that may not be visible on mammograms or ultrasound.
MRI has high sensitivity but low specificity, meaning it can detect potential lesions but may struggle to differentiate between benign and malignant conditions. As a result, MRI often identifies lesions that require further evaluation, particularly when these are not seen on initial ultrasound.
MRI-Detected Lesions
One issue with MRI-detected lesions is that many appear as non-mass enhancement (NME) or small, indistinct lesions. These are difficult to assess with standard ultrasound. MRI-detected lesions vary in appearance, with some classified as category 2 or 3 on initial ultrasound. Others may show ductal dilatation with minimal secretory accumulation or cyst-like lesions. Ultrasound detection of these lesions is often low, with studies showing that around 70% are missed. However, second-look ultrasound, guided by anatomical landmarks, has significantly improved detection rates, reaching 87–99%.
Despite these advances, the percentage of malignancy among these lesions remains around 30%.
The aim of this review is to explore the current methods for evaluating MRI-detected lesions, with a focus on second-look ultrasound techniques. These methods include MRI-targeted ultrasound, which utilizes the anatomical features surrounding the lesion to improve detection accuracy. The review also discusses the lack of uniform criteria for second-look Ultrasound diagnosis and the need for clearer guidelines to ensure consistent and effective evaluation of MRI-detected lesions. Ultimately, the review emphasizes the importance of a multidisciplinary approach to managing MRI-detected lesions in breast cancer diagnosis and surveillance.
