Diagnostic accuracy of contrast-enhanced breast mri in suspicious breast lesions:  A prospective observational study with histopathological correlation.

Dr. Puppala Sirisha  Naidu; Dr. Roja  Dwarampudi; Dr. Bharat  Kakileti; Dr Anand  Acharya

doi:10.51168/sjhrafrica.v6i12.2354

Authors

Dr. Puppala Sirisha Naidu Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
Dr. Roja Dwarampudi Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
Dr. Bharat Kakileti Associate Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
Dr. Anand Acharya Dean and Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2354

Keywords:

Breast magnetic resonance imaging, Contrast-enhanced magnetic resonance imaging, Breast cancer, Suspicious breast lesions, Diagnostic accuracy, Histopathology

Abstract

Background
Accurate characterization of suspicious breast lesions is central to early diagnosis and optimal management of breast cancer. While mammography and ultrasonography are frontline tools, their diagnostic performance may be limited in dense breasts and complex lesions.

Objective

To assess the diagnostic performance of contrast-enhanced breast MRI in differentiating benign from malignant breast lesions, using histopathology as the reference standard.

Materials and Methods

This prospective observational study included 100 female patients presenting with suspicious breast lesions categorized as BI-RADS 4 or 5 on mammography or ultrasonography. All participants underwent contrast-enhanced breast MRI followed by histopathological confirmation through core needle biopsy or surgical excision. MRI evaluation focused on lesion morphology, internal architecture, enhancement characteristics, and kinetic curve patterns. Diagnostic indices, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy, were calculated by comparing MRI findings with histopathological results.

Results

Histopathology confirmed 65 malignant and 35 benign lesions. Breast MRI correctly identified 60 malignant and 25 benign lesions. The sensitivity was 92.3%, specificity 71.4%, positive predictive value 85.7%, negative predictive value 83.3%, and overall diagnostic accuracy 85%. Overall agreement between MRI and histopathology was 85%, demonstrating strong concordance.

Conclusion

Contrast-enhanced breast MRI is a highly sensitive and dependable modality for evaluating suspicious breast lesions. It serves as an effective adjunct to conventional imaging, improves lesion characterization, and supports accurate clinical decision-making.

Recommendations:

Contrast-enhanced breast MRI should be routinely considered in patients with BI-RADS 4–5 lesions, equivocal findings on conventional imaging, or dense breast parenchyma. Integration of advanced functional techniques, such as diffusion-weighted imaging and quantitative kinetic analysis, may enhance specificity and reduce unnecessary biopsies.

Author Biographies

Dr. Puppala Sirisha Naidu, Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

is an Assistant Professor in the Department of Radiology at Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India. Her academic interests include cardiovascular imaging, cross-sectional imaging, and advanced MRI applications. She is actively involved in undergraduate and postgraduate teaching and has contributed to clinical research focused on the diagnostic and prognostic role of imaging modalities.

Dr. Roja Dwarampudi, Assistant Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

is an Assistant Professor in the Department of Radiology at Konaseema Institute of Medical Sciences, Amalapuram. Her professional interests encompass diagnostic radiology, MRI interpretation, and radiological correlation with clinical outcomes. She is engaged in teaching, clinical service, and collaborative research activities within the department.

Dr. Bharat Kakileti, Associate Professor, Department of Radiology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

is an Associate Professor in the Department of Radiology at Konaseema Institute of Medical Sciences, Amalapuram. He has extensive experience in diagnostic radiology with special expertise in cardiac MRI and body imaging. His academic work includes mentoring postgraduate students and participating in institutional research projects aimed at improving imaging-based clinical decision-making.

Dr. Anand Acharya, Dean and Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

MBBS, MD (Pharmacology), currently serves as Dean and Professor, Department of Pharmacology, at the Konaseema Institute of Medical Sciences & Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh, India. A distinguished academician, researcher, and medical education leader, he has been pivotal in transforming KIMS&RF from its formative phase into a premier medical institution with over 200 undergraduate and 100 postgraduate seats.

With more than 18 years of teaching and administrative experience, Dr. Acharya has held several leadership positions, including Vice Principal, Principal, Chief Warden, Member Secretary of Institutional Ethics and Animal Ethics Committees, and is an approved PhD Guide under Dr. NTR University of Health Sciences, Vijayawada. His visionary leadership has significantly enhanced the institution’s academic quality, clinical exposure, research infrastructure, and postgraduate training standards.

He has completed prestigious national faculty development programs such as the Revised Basic Course Workshop (rBCW), Advanced Course in Medical Education (ACME), and National Teacher Training Course (NTTC, JIPMER, Puducherry). He also serves as Coordinator for Pharmacovigilance and Materiovigilance Programs under IPC–PvPI and MoHFW, Government of India, contributing actively to national drug safety and regulatory initiatives.

A prolific academician, Dr. Acharya has authored and co-authored more than 100 scientific publications in reputed national and international indexed journals. His wide-ranging research covers toxicology, pharmacovigilance, antimicrobial resistance, endocrinology, neuropharmacology, and clinical pharmacology. His recent studies include long-term analyses of pyrethroid, paraquat, and chlorpyrifos poisoning, investigations into antimicrobial resistance trends, and predictive models for treatment outcomes in dermatological and toxicological emergencies.

Dr. Acharya’s professional interests include clinical pharmacology, toxicovigilance, rational drug use, pharmacovigilance systems, and innovations in medical education technologies. He continues to mentor numerous postgraduate and undergraduate researchers while playing an integral role in curriculum reform, ethics governance, and institutional academic advancement.ORCID iD: https://orcid.org/0009-0000-7967-9092

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