Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among American women. It is estimated that one out of every nine women will develop breast cancer in her lifetime. While mammography has clearly become the gold standard in the detection of early, clinically occult breast cancer, it has limitations. These limitations in mammography have led to interest in developing new forms of breast imaging that may offer both higher sensitivity and higher specificity. Contrast-enhanced magnetic resonance (MR) imaging of the breast has been shown to be a potentially powerful technique for the detection and diagnosis of breast cancer. Researchers have developed an interpretation model based on architectural features extracted from high-resolution breast MR images that has a high sensitivity for malignant disease. Other research has shown that an analysis of the time course enhancement can be used to predict malignant disease. Unfortunately, simultaneous acquisition of both high resolution and temporal data has been difficult due to their diverging demands. We have developed an imaging method that allows us to reconstruct high spatial resolution images, as well high temporal resolution images, using the same data. With both kinetic and architectural enhancement data at our disposal, the overall goal of this study is to create a combined interpretation model. Three hundred women with suspected breast lesions are to be imaged over a three-year period. The first 100 subjects will be used to complete construction of the combined interpretation model. With the remaining two hundred exams, the model will be evaluated for the diagnostic performance characteristics (sensitivity, specificity, positive predictive value [PPV], and the negative predictive value [NPV]) of the overall model in differentiating benign from malignant masses. With an effective prediction model, MR imaging can be a cost-effective step in the evaluation of patients with suspicious breast findings including a viable alternative to breast biopsy in some patients.
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