Importance of magnetic resonance imaging in patients with fibrocystic changes.

Introduction: A proper detection of atypical epithelial hyperplasia (component of FCC) without missing the coexistent malign disease is the main problem in evaluating the FCC-affected patients. For some patients, it is not enough to use only mammography and ultrasonography in pursuit or decision biopsy. Magnetic resonance imaging (MRI) may be important in these patients. Nevertheless, the MRI features of FCC are not clearly known because there are very few studies specifically focused on FCC. Studies reporting on MRI of breast fibrocystic changes are very scarce and their MRI findings are not clearly known. The aim of this study was to determine the MRI characteristics of fibrocystic changes.

Methods: Twenty-six patients with pathologically proven fibrocystic changes of the breast were retrospectively reviewed. The MRI study was performed using 1.5 T MR scanner with a phase array bilateral breast coil. The imaging protocol consisted of pre-contrast T1-weighted imaging and bilateral dynamic 3D contrast-enhanced imaging. The morphologic and kinetic features of fibrocystic changes on MRI were evaluated.

Results: Twenty-four patients showed benign enhancement kinetics (type 1), while 2 patients showed malignant enhancement kinetics (type 2).

Conclusion: To our knowledge, the analysis of enhancement kinetics may be more useful in identifying atypical epithelial hyperplasia and cancer from other breast lesions provided that corrections are made for the true phase of menstrual cycle (Tab. 1, Fig. 1, Ref. 10).