False negative carcinomas on breast magnetic resonance imaging: histological types, enhancement pattern and background parenchymal enhancement

Abstract

Background Magnetic resonance imaging MRI is the most sensitive imaging method for breast cancer detection Its introduction in breast cancer screening programs has been discussed in the last decade Currently in combination with mammography the gold standard screening method MRI is recommended to screen women at high genetic risk for developing breast cancer Despite its high sensitivity to detect breast cancer few articles discuss the presence of false negative results obtained by the MRI exam and the reasons for these results False negative results associated with an inadequate study method the histological lesion type and the background breast parenchymal enhancement pattern are reported in the literature For example concerning the histological type low grade ductal carcinoma in situ DCIS is considered to be related to the lack of lesion enhancement in the dynamic phases which is a determinant for the negative result Regarding the background enhancement pattern it is believed that moderate and intense patterns have a higher correlation with false negative results Main body This study aims to discuss the reasons for false negative MRI results using cases studied in our department The discussion is based on cases of breast carcinoma diagnosis that were negative on MRI studies The enhancement patterns of breast masses were correlated with the background enhancement pattern and the histological tumor type The cases included DCIS invasive ductal carcinoma invasive lobular carcinoma and interval carcinoma Conclusion False negative MRI results can occur in all three types of kinetic curves All carcinomas show enhancement after the injection of contrast however if the enhancement is identical to the parenchyma its presence is not noticeable It is always important to consider the assessment of the spatial morphology of the lesion by MRI