Retrospective Evaluation of Magnetic Resonance Imaging Findings for BI-RADS 5 Lesions: A 5-year Clinical Experience

Objectives: This study aimed to evaluate the diagnostic utility of magnetic resonance imaging (MRI) for breast cancer detection, focusing specifically on Breast Imaging-Reporting and Data System (BI-RADS) 5 lesions.The study investigated the morphological and dynamic characteristics of these lesions using MRI to identify features associated with malignancy.Methods: A retrospective analysis was conducted on breast MRI scans performed between January 2019 and December 2023.The study included 120 patients with BI-RADS 5 lesions who underwent biopsy or surgical excision.MRI images were evaluated for breast parenchymal patterns, T2-weighted signal characteristics, lesion size, location, enhancement kinetics, and morphological features using a standardized protocol.Histopathological results were correlated with MRI findings.Results: Among the 120 BI-RADS 5 lesions, 109 were malignant and 11 benign.Malignant lesions predominantly exhibited heterogeneous enhancement patterns (69.7%) and hypointense T2-weighted signals (56%).Most malignant lesions (82.3%) showed washout enhancement kinetics.Benign lesions, on the other hand, exhibited predominantly hyperintense T2-weighted signals (63.6%) and heterogeneous enhancement patterns (54.5%).Due to the small number of benign lesions, statistical comparisons between the malignant and benign groups were limited. Conclusion:Breast MRI, particularly for BI-RADS 5 lesions, plays a critical role in the detection and characterization of breast cancer.The detailed assessment of morphological and dynamic features by MRI aids in accurate diagnosis and treatment planning.Understanding these MRI findings will enhance clinical decision-making and reduce unnecessary surgical interventions in patients with suspicious breast lesions.