Additional findings at preoperative breast MRI: the value of second-look digital breast tomosynthesis

Objectives To evaluate second-look digital breast tomosynthesis (SL-DBT) for additional findings (AFs) at preoperative MRI compared with second-look ultrasound (SL-US). Methods We included 135 patients with breast cancer who underwent digital mammography (DM), DBT, US, and MRI at two centres. MR images were retrospectively evaluated to find AFs, described as focus, mass, or non-mass; ≤10 mm or >10 mm in size; BI-RADS 3, 4, or 5. DM and DBT exams were reviewed looking for MRI AFs; data on SL-US were collected. Reference standard was histopathology or ≥12-month negative follow-up. Fisher exact test and McNemar test were used. Results Eighty-four AFs were detected in 53/135 patients (39 %, 95 %CI 31–48 %). A correlate was found for 44/84 (52 %, 95 %CI 41–63 %) at SL-US, for 20/84 (24 %, 95 %CI 11–28 %) at SL-DM, for 42/84 (50 %, 95 %CI 39–61 %) at SL-DBT, for 63/84 (75 %, 95 %CI 64–84 %) at SL-DBT, and/or SL-US, the last rate being higher than for SL-US only, overall ( p 10 mm, BI-RADS 4 or 5, or malignant lesions ( p