Multiple, scattered, separated by normal tissue: Considered background parenchymal enhancement (BPE)
Not confluent or grouped within small area
Distinguish from focal area(s) clumped enhancement
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Spick C et al: Breast lesions classified as probably benign (BI-RADS 3) on magnetic resonance imaging: a systematic review and meta-analysis. Eur Radiol. 28(5):1919-28, 2018
Gweon HM et al: Management for BI-RADS category 3 lesions detected in preoperative breast MR imaging of breast cancer patients. Eur Radiol. 27(8):3211-3216, 2017
Machida Y et al: Single focus on breast magnetic resonance imaging: diagnosis based on kinetic pattern and patient age. Acta Radiol. 58(6):652-659, 2017
Uematsu T et al: Real-time virtual sonography examination and biopsy for suspicious breast lesions identified on MRI alone. Eur Radiol. 26(4):1064-72, 2016
Grimm LJ et al: Frequency of malignancy and imaging characteristics of probably benign lesions seen at breast MRI. AJR Am J Roentgenol. 205(2):442-7, 2015
Ha R et al: Breast magnetic resonance imaging: management of an enhancing focus. Radiol Clin North Am. 52(3):585-9, 2014
Morris EA et al: Breast Imaging Reporting and Data System, BI-RADS: Magnetic Resonance Imaging. 2nd ed. Reston: American College of Radiology, 2013
Mahoney MC et al: Positive predictive value of BI-RADS MR imaging. Radiology. 264(1):51-8, 2012
Raza S et al: Small masses on breast MR: is biopsy necessary? Acad Radiol. 19(4):412-9, 2012
Candelaria R et al: Second-look US examination of MR-detected breast lesions. J Clin Ultrasound. 39(3):115-21, 2011
Demartini WB et al: Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics. Eur Radiol. 21(8):1609-17, 2011
Jansen SA et al: The diverse pathology and kinetics of mass, nonmass, and focus enhancement on MR imaging of the breast. J Magn Reson Imaging. 33(6):1382-9, 2011
Abe H et al: MR-directed ("Second-Look") ultrasound examination for breast lesions detected initially on MRI: MR and sonographic findings. AJR Am J Roentgenol. 194:370-7; 2010
Dietzel M et al: Differential diagnosis of breast lesions 5 mm or less: is there a role for magnetic resonance imaging? J Comput Assist Tomogr. 34(3):456-64, 2010
Obdeijn IM et al: Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition. Breast Cancer Res Treat. 119(2):399-407, 2010
Weinstein SP et al: Frequency of malignancy seen in probably benign lesions at contrast-enhanced breast MR imaging: findings from ACRIN 6667. Radiology. 255(3):731-7, 2010
Demartini WB et al: Utility of targeted sonography for breast lesions that were suspicious on MRI. AJR Am J Roentgenol. 192(4):1128-34, 2009
Eby PR et al: Characteristics of probably benign breast MRI lesions. AJR Am J Roentgenol. 2009;193:861-7
Chen JH et al: Fibrocystic change of the breast presenting as a focal lesion mimicking breast cancer in MR imaging. J Magn Reson Imaging. 28(6):1499-505, 2008
Han BK et al: Outcome of MRI-guided breast biopsy. AJR Am J Roentgenol. 191(6):1798-804, 2008
Van den Bosch MA et al: Does size matter? Likelihood of cancer in MRI-detected lesions less than 5 mm. AJR Am J Roentgenol. 188(6):W571, 2007
Liberman L et al: Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 186(2):426-30, 2006
Yabuuchi H et al: Incidentally detected lesions on contrast-enhanced MR imaging in candidates for breast-conserving therapy: Correlation between MR findings and histological diagnosis. J Magn Reson Imaging. 23(4):486-92, 2006
Delille JP et al: Physiologic changes in breast magnetic resonance imaging during the menstrual cycle: perfusion imaging, signal enhancement, and influence of the T1 relaxation time of breast tissue. Breast J. 11(4):236-41, 2005
Sadowski EA et al: Frequency of malignancy in lesions classified as probably benign after dynamic contrast-enhanced breast MRI examination. J Magn Reson Imaging. 21(5):556-64, 2005
Tozaki M et al: High-spatial-resolution MR imaging of focal breast masses: interpretation model based on kinetic and morphological parameters. Radiat Med. 23(1):43-50, 2005
Liberman L et al: Probably benign lesions at breast magnetic resonance imaging: preliminary experience in high-risk women. Cancer. 98(2):377-88, 2003
Teifke A et al: Outcome analysis and rational management of enhancing lesions incidentally detected on contrast-enhanced MRI of the breast. AJR Am J Roentgenol. 181(3):655-62, 2003
Heinig A et al: Suppression of unspecific enhancement on breast magnetic resonance imaging (MRI) by antiestrogen medication. Tumori. 88(3):215-23, 2002
Yuh EL et al: Clinical outcomes of incidental enhancing lesions detected on contrast-enhanced breast MRI. Radiology. 225:325-6 (abstr), 2002
Brown J et al: Incidental enhancing lesions found on MR imaging of the breast. AJR Am J Roentgenol. 176(5):1249-54, 2001
Kuhl CK et al: Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency. Radiology. 203(1):137-44, 1997
Nunes LW et al: Breast MR imaging: interpretation model. Radiology. 202(3):833-41, 1997
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Punctate nonspecific enhancement
Early literature, no longer used: Incidental enhancing lesions (IELs), unidentified bright objects (UBOs)
Definitions
Tiny dot of contrast enhancement, ≤ 4 mm, too small to characterize morphologically
Multiple, scattered, separated by normal tissue: Considered background parenchymal enhancement (BPE)
Not confluent or grouped within small area
Distinguish from focal area(s) clumped enhancement
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
Image-Guided Biopsy
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Spick C et al: Breast lesions classified as probably benign (BI-RADS 3) on magnetic resonance imaging: a systematic review and meta-analysis. Eur Radiol. 28(5):1919-28, 2018
Gweon HM et al: Management for BI-RADS category 3 lesions detected in preoperative breast MR imaging of breast cancer patients. Eur Radiol. 27(8):3211-3216, 2017
Machida Y et al: Single focus on breast magnetic resonance imaging: diagnosis based on kinetic pattern and patient age. Acta Radiol. 58(6):652-659, 2017
Uematsu T et al: Real-time virtual sonography examination and biopsy for suspicious breast lesions identified on MRI alone. Eur Radiol. 26(4):1064-72, 2016
Grimm LJ et al: Frequency of malignancy and imaging characteristics of probably benign lesions seen at breast MRI. AJR Am J Roentgenol. 205(2):442-7, 2015
Ha R et al: Breast magnetic resonance imaging: management of an enhancing focus. Radiol Clin North Am. 52(3):585-9, 2014
Morris EA et al: Breast Imaging Reporting and Data System, BI-RADS: Magnetic Resonance Imaging. 2nd ed. Reston: American College of Radiology, 2013
Mahoney MC et al: Positive predictive value of BI-RADS MR imaging. Radiology. 264(1):51-8, 2012
Raza S et al: Small masses on breast MR: is biopsy necessary? Acad Radiol. 19(4):412-9, 2012
Candelaria R et al: Second-look US examination of MR-detected breast lesions. J Clin Ultrasound. 39(3):115-21, 2011
Demartini WB et al: Probability of malignancy for lesions detected on breast MRI: a predictive model incorporating BI-RADS imaging features and patient characteristics. Eur Radiol. 21(8):1609-17, 2011
Jansen SA et al: The diverse pathology and kinetics of mass, nonmass, and focus enhancement on MR imaging of the breast. J Magn Reson Imaging. 33(6):1382-9, 2011
Abe H et al: MR-directed ("Second-Look") ultrasound examination for breast lesions detected initially on MRI: MR and sonographic findings. AJR Am J Roentgenol. 194:370-7; 2010
Dietzel M et al: Differential diagnosis of breast lesions 5 mm or less: is there a role for magnetic resonance imaging? J Comput Assist Tomogr. 34(3):456-64, 2010
Obdeijn IM et al: Assessment of false-negative cases of breast MR imaging in women with a familial or genetic predisposition. Breast Cancer Res Treat. 119(2):399-407, 2010
Weinstein SP et al: Frequency of malignancy seen in probably benign lesions at contrast-enhanced breast MR imaging: findings from ACRIN 6667. Radiology. 255(3):731-7, 2010
Demartini WB et al: Utility of targeted sonography for breast lesions that were suspicious on MRI. AJR Am J Roentgenol. 192(4):1128-34, 2009
Eby PR et al: Characteristics of probably benign breast MRI lesions. AJR Am J Roentgenol. 2009;193:861-7
Chen JH et al: Fibrocystic change of the breast presenting as a focal lesion mimicking breast cancer in MR imaging. J Magn Reson Imaging. 28(6):1499-505, 2008
Han BK et al: Outcome of MRI-guided breast biopsy. AJR Am J Roentgenol. 191(6):1798-804, 2008
Van den Bosch MA et al: Does size matter? Likelihood of cancer in MRI-detected lesions less than 5 mm. AJR Am J Roentgenol. 188(6):W571, 2007
Liberman L et al: Does size matter? Positive predictive value of MRI-detected breast lesions as a function of lesion size. AJR Am J Roentgenol. 186(2):426-30, 2006
Yabuuchi H et al: Incidentally detected lesions on contrast-enhanced MR imaging in candidates for breast-conserving therapy: Correlation between MR findings and histological diagnosis. J Magn Reson Imaging. 23(4):486-92, 2006
Delille JP et al: Physiologic changes in breast magnetic resonance imaging during the menstrual cycle: perfusion imaging, signal enhancement, and influence of the T1 relaxation time of breast tissue. Breast J. 11(4):236-41, 2005
Sadowski EA et al: Frequency of malignancy in lesions classified as probably benign after dynamic contrast-enhanced breast MRI examination. J Magn Reson Imaging. 21(5):556-64, 2005
Tozaki M et al: High-spatial-resolution MR imaging of focal breast masses: interpretation model based on kinetic and morphological parameters. Radiat Med. 23(1):43-50, 2005
Liberman L et al: Probably benign lesions at breast magnetic resonance imaging: preliminary experience in high-risk women. Cancer. 98(2):377-88, 2003
Teifke A et al: Outcome analysis and rational management of enhancing lesions incidentally detected on contrast-enhanced MRI of the breast. AJR Am J Roentgenol. 181(3):655-62, 2003
Heinig A et al: Suppression of unspecific enhancement on breast magnetic resonance imaging (MRI) by antiestrogen medication. Tumori. 88(3):215-23, 2002
Yuh EL et al: Clinical outcomes of incidental enhancing lesions detected on contrast-enhanced breast MRI. Radiology. 225:325-6 (abstr), 2002
Brown J et al: Incidental enhancing lesions found on MR imaging of the breast. AJR Am J Roentgenol. 176(5):1249-54, 2001
Kuhl CK et al: Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency. Radiology. 203(1):137-44, 1997
Nunes LW et al: Breast MR imaging: interpretation model. Radiology. 202(3):833-41, 1997
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