Breast MRI in the setting of breast carcinoma with suspected microcalcifications and his predictive value in breast cancer management: An interesting case report

The Breast Imaging Reporting and Data System (BI-RADS®) is a standardized system of reporting breast pathology used also for Magnetic Resonance Imaging (MRI). It facilitates clear communication between the radiologist and other physicians as surgeons involved in senology, by providing a lexicon that compares breast gland structures to assessment categories in the management recommendations for the onco-surgical choices. In 30% of all clinical cases in women, breast cancer is correlated to micro-calcifications [1] or occulted lesion as non-palpable nodule and this diagnostic management is not easy, especially if you haven’t an easy access to all the equipment of interventional methods as stereotactic biopsy or radio-pharmacological detection’s method (for example R.O.L.L., Radioguided Occult Breast Lesion Location), and if you cannot know the real distribution of suspected or malignant microcalcifications in mammography. MRI is more accurate than mammography for prediction of residual malignancy after excisional biopsy for breast cancer with suspicious micro-calcifications [2,3]. MRI’s report often influences the surgical performance. MRI can be useful to correlate malignant microcalcifications with pathological tumor size and to allow the pre-operative drawing in onco-plastic surgery for breast cancer. MRI might be more reliable for predicting residual tumor size after an onco-plastic surgical procedure or a conservative mastectomy, with significant influence on surgical outcomes and disease free survival and risk of relapse [4,5]. Keywords: Breast cancer; Breast MRI; Microcalcifications; Multidisciplinary consultation; Breast conservative surgery.