What question did this study set out to answer?

This study investigates diffusion-weighted imaging (DWI) for differentiating breast lesions and its association with histological subtypes and prognostic factors.

June 17, 2026

Diagnostic Performance of Diffusion‐Weighted Imaging for Evaluation of Breast Lesions: Correlation With Prognostic Factors and Histological Phenotypes

Key Points

This study investigates diffusion-weighted imaging (DWI) for differentiating breast lesions and its association with histological subtypes and prognostic factors.
Retrospective study involving 456 patients who underwent ultrasound-guided tru-cut biopsy between January 2024 and January 2025.
DWI sequences and ADC values were measured to evaluate breast lesions.
Statistical analysis determined differences in ADC values between benign and malignant lesions.
Mean ADC values showed a significant difference between benign (1.22 ± 0.24) and malignant lesions (0.76 ± 0.18) with p < 0.001.
ADC mean cut-off value was established at 0.955 × 10 −3 mm 2 /s (p < 0.001).
Significant difference in ADC ratio between HER2-negative (0.56 ± 0.12) and HER2-positive (0.49 ± 0.14) cases was found (p = 0.043).

Abstract

ABSTRACT Purpose To investigate the role of diffusion‐weighted imaging (DWI) in the differential diagnosis of breast lesions and to determine whether there is an association with histological subtypes and prognostic factors. Materials & Methods This retrospective study was approved by our institution's ethics committee. A total of 456 patients who underwent ultrasound‐guided tru‐cut biopsy between January 2024 and January 2025 were evaluated. Patients who had pre‐biopsy breast MRI examinations with diagnostically adequate DWI sequences were included. Apparent diffusion coefficient values (ADC mean and ADC ratio ) were measured. Results The mean age of the patients was 46.79 ± 12.55 years. A total of 96 breast masses were evaluated in the study, of which 44.79% ( n = 43) were benign, and 55.21% ( n = 53) were malignant. A statistically significant difference was observed between the benign group (1.22 ± 0.24 × 10 −3 mm 2 /s) and the malignant group (0.76 ± 0.18 × 10 −3 mm 2 /s) in terms of ADC mean values ( p 0.05). A statistically significant difference in ADC ratio values was observed between HER2‐negative cases (0.56 ± 0.12) and HER2‐positive cases (0.49 ± 0.14) ( p = 0.043). Conclusion DWI and ADC represent reliable methods for distinguishing between benign and malignant breast lesions. The observed association between ADC ratio values and HER2 expression suggests that this parameter may be useful in identifying breast cancer patients with poor prognostic profiles.

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