Comparative Study Of Mammography Versus Magnetic Resonance Imaging With Breast Adenosis And Non-calcified Breast Cancer

ObjectiveTo compare the diagnostic efficiency of mammography(MG)and MRI in breast adenosis and non-calcified breast cancer,and also to analyze the different features in MRI in the two groups in order to improve the diagnostic accuracy of breast adenosis and non-calcified breast cancer.Materials and methodsClinical,pathological,and radiographic data of 84 cases with breast adenosis and 105 cases with breast cancer were retrospectively collected,all cases were confirmed by surgery or aspiration pathology.Each subject underwent both MG and MRI and presented as non-calcified lesion on the MG.All MG and MRI images were analyzed according to the Breast Imaging Reporting and Data System(BI-RADS)recommended by the American College of Radiology(2013).The statistical software SPSS26.0 was used to compare the diagnostic efficacy of MG and MRI(including dynamic enhancement imaging(DCE),diffusion-weighted imaging(DWI)and combination of the two)and to obtain the ROC curve,and also compared the differences in clinical and MRI characteristics between breast adenosis and non-calcified breast cancer.Statistically significant features were then used to perform multivariate binary logistic regression analysis.Results1.The clinical features of the two groups showed statistical differences in age,activity and pain of the lesion.2.MRI was better than MG in the diagnosis of breast adenosis and non-calcified breast cancer,and DCE-MRI had the highest sensitivity,DWI had the highest specificity,accuracy and AUC with the cutoff point of ADC value as 0.816 X 10-3mm2/s,while the diagnostic accuracy of MG was the lowest.Combined with DCE-MRI and DWI,the sensitivity and NPV were increased,but the specificity and PPV were decreased,which easily led to misdiagnosis of breast adenosis.3.For mass lesions,two group between breast adenosis and non-calcified breast cancer showed statistically differences in size,lobulation,burr,early strengthening curve,late strengthening curve,early phase enhancement rate and in the average ADC values.According to logistics regression analysis,burr,washout kinetic,age,and average ADC value are the key factors for lesion identification between the two groups,with OR values of 7.122,6.151,1.167 and 0.996.For non-mass lesions,there were statistically differences between the two groups in lesion distribution,early enhancement curve,late enhancement curve and average ADC value,while there was no statistical difference in internal enhancement mode.ConclusionThe diagnostic efficiency of MRI for breast adenosis and non-calcified breast cancer was generally better than that of MG,which DCE-MRI has an advantage in the accurate diagnosis of non-calcified breast cancer,and DWI had an advantage in the accurate diagnosis of breast adenosis.Breast adenosis could be similar to non-calcified breast cancer in morphology,dynamic enhancement characteristics and DWI,and it should be necessary to combine the clinical characteristics of the patient and a variety of imaging examinations when the differentiation is difficult.