---
title: "Abbreviated Breast MRI for Suspicious Microcalcifications: Diagnostic Performance and Reader Agree"
id: "pubmed-42674718"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674718"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674718/"
doi: "10.21873/anticanres.18355"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Abbreviated Breast MRI for Suspicious Microcalcifications: Diagnostic Performance and Reader Agree
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674718
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674718/)
- **DOI:** [10.21873/anticanres.18355](https://doi.org/10.21873%2Fanticanres.18355)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study evaluated an **abbreviated breast MRI** reading protocol as an adjunctive tool for assessing suspicious mammographic **microcalcifications** detected in a screening-like cohort. - Prospective single-center study included 58 women (mean age 58±24 years) with 59 suspicious microcalcification sites; 68 lesions had histopathologic verification. - MRI datasets were read independently by four radiologists with 5–15 years’ experience, blinded to mammography, using a standardized abbreviated protocol (maximum intensity projection, early post-contrast subtraction, and native images). - Overall, 21 lesions were malignant and 38 benign among the 59 microcalcification lesions considered; no invasive carcinomas were missed by any reader. - Per-reader sensitivity ranged 74–83%, specificity 58–83%, positive predictive value 56–75%, negative predictive value 83–86%, and accuracy 68–81%. - False-negative MRI assessments were exclusively **ductal carcinoma in situ (DCIS)** lesions; invasive cancers were detected by all readers. - MIP-only readings had markedly lower sensitivity (48–52%) despite higher specificity (83–94%), indicating insufficient diagnostic reliability when used alone. - Mean reading times using the abbreviated protocol ranged from 1 minute 42 seconds to 3 minutes 26 seconds, demonstrating time efficiency. - Interreader agreement for the final recall decision was moderate (Fleiss’ κ = 0.47); pairwise Cohen’s κ values ranged 0.40–0.53. - Authors conclude abbreviated breast MRI is feasible and time-efficient with consistent diagnostic performance across readers but recommend further evaluation before broader screening implementation; MIP-only approaches are not adequate for this task.
## Clinical Analysis & Structured Key Points
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patrik.poeschke@uk-erlangen.de.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Evelyn Wenkel](https://pubmed.ncbi.nlm.nih.gov/?term=Wenkel+E&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-5 "Diagnosticum Bayern Mitte, Roth, Germany."), [Carla Schulmeyer](https://pubmed.ncbi.nlm.nih.gov/?term=Schulmeyer+C&cauthor_id=42674718)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-6 "Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN \(CCC ER-EMN\)/Friedrich Alexander University of Erlangen-Nuremberg \(FAU\), Erlangen, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Carolin C Hack](https://pubmed.ncbi.nlm.nih.gov/?term=Hack+CC&cauthor_id=42674718)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-6 "Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN \(CCC ER-EMN\)/Friedrich Alexander University of Erlangen-Nuremberg \(FAU\), Erlangen, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Matthias W Beckmann](https://pubmed.ncbi.nlm.nih.gov/?term=Beckmann+MW&cauthor_id=42674718)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-6 "Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN \(CCC ER-EMN\)/Friedrich Alexander University of Erlangen-Nuremberg \(FAU\), Erlangen, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Rolf Janka](https://pubmed.ncbi.nlm.nih.gov/?term=Janka+R&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany."), [Barbara Brehm](https://pubmed.ncbi.nlm.nih.gov/?term=Brehm+B&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-7 "Evidia MVZ Radiologie Franken GmbH, Fürth, Germany."), [Sandra C Peter](https://pubmed.ncbi.nlm.nih.gov/?term=Peter+SC&cauthor_id=42674718)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-8 "Institut für Bildgebende Diagnostik und Therapie, BDT-MVZ Betriebs GmbH, Erlangen-Tennenlohe, Germany."), [Sabine Ohlmeyer](https://pubmed.ncbi.nlm.nih.gov/?term=Ohlmeyer+S&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#full-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany.") Affiliations Expand ### Affiliations * 1 Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN)/Friedrich Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany; patrik.poeschke@uk-erlangen.de. * 2 Comprehensive Cancer Center Alliance WERA (CCC), Erlangen, Germany. * 3 Bavarian Center for Cancer Research (BZKF), Erlangen, Germany. * 4 Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany. * 5 Diagnosticum Bayern Mitte, Roth, Germany. * 6 Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN)/Friedrich Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany. * 7 Evidia MVZ Radiologie Franken GmbH, Fürth, Germany. * 8 Institut für Bildgebende Diagnostik und Therapie, BDT-MVZ Betriebs GmbH, Erlangen-Tennenlohe, Germany. * PMID: **42674718** * DOI: [ 10.21873/anticanres.18355 ](https://doi.org/10.21873/anticanres.18355) Item in Clipboard # Breast MRI With Abbreviated Reading Protocol as Additional Evaluation Tool for Suspicious Microcalcifications in a Screening Cohort: Diagnostic Performance and Interreader Agreement Patrik Pöschke et al. Anticancer Res. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Anticancer Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anticancer+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Anticancer+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674718/) . 2026 Sep;46(9):5067-5079. doi: 10.21873/anticanres.18355. ### Authors [Patrik Pöschke](https://pubmed.ncbi.nlm.nih.gov/?term=P%C3%B6schke+P&cauthor_id=42674718)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-1 "Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN \(CCC ER-EMN\)/Friedrich Alexander University of Erlangen-Nuremberg \(FAU\), Erlangen, Germany; patrik.poeschke@uk-erlangen.de.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Evelyn Wenkel](https://pubmed.ncbi.nlm.nih.gov/?term=Wenkel+E&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-5 "Diagnosticum Bayern Mitte, Roth, Germany."), [Carla Schulmeyer](https://pubmed.ncbi.nlm.nih.gov/?term=Schulmeyer+C&cauthor_id=42674718)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-6 "Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN \(CCC ER-EMN\)/Friedrich Alexander University of Erlangen-Nuremberg \(FAU\), Erlangen, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Carolin C Hack](https://pubmed.ncbi.nlm.nih.gov/?term=Hack+CC&cauthor_id=42674718)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-6 "Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN \(CCC ER-EMN\)/Friedrich Alexander University of Erlangen-Nuremberg \(FAU\), Erlangen, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Matthias W Beckmann](https://pubmed.ncbi.nlm.nih.gov/?term=Beckmann+MW&cauthor_id=42674718)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-6 "Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN \(CCC ER-EMN\)/Friedrich Alexander University of Erlangen-Nuremberg \(FAU\), Erlangen, Germany.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-3 "Bavarian Center for Cancer Research \(BZKF\), Erlangen, Germany."), [Rolf Janka](https://pubmed.ncbi.nlm.nih.gov/?term=Janka+R&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany."), [Barbara Brehm](https://pubmed.ncbi.nlm.nih.gov/?term=Brehm+B&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-7 "Evidia MVZ Radiologie Franken GmbH, Fürth, Germany."), [Sandra C Peter](https://pubmed.ncbi.nlm.nih.gov/?term=Peter+SC&cauthor_id=42674718)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-2 "Comprehensive Cancer Center Alliance WERA \(CCC\), Erlangen, Germany.")[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-8 "Institut für Bildgebende Diagnostik und Therapie, BDT-MVZ Betriebs GmbH, Erlangen-Tennenlohe, Germany."), [Sabine Ohlmeyer](https://pubmed.ncbi.nlm.nih.gov/?term=Ohlmeyer+S&cauthor_id=42674718)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674718/#short-view-affiliation-4 "Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany.") ### Affiliations * 1 Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN)/Friedrich Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany; patrik.poeschke@uk-erlangen.de. * 2 Comprehensive Cancer Center Alliance WERA (CCC), Erlangen, Germany. * 3 Bavarian Center for Cancer Research (BZKF), Erlangen, Germany. * 4 Institut of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany. * 5 Diagnosticum Bayern Mitte, Roth, Germany. * 6 Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN)/Friedrich Alexander University of Erlangen-Nuremberg (FAU), Erlangen, Germany. * 7 Evidia MVZ Radiologie Franken GmbH, Fürth, Germany. * 8 Institut für Bildgebende Diagnostik und Therapie, BDT-MVZ Betriebs GmbH, Erlangen-Tennenlohe, Germany. * PMID: **42674718** * DOI: [ 10.21873/anticanres.18355 ](https://doi.org/10.21873/anticanres.18355) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aim:** Biopsy of suspicious microcalcifications (MC) detected in breast cancer screening yields benign results in the majority of cases, resulting in a substantial number of avoidable interventions. While magnetic resonance imaging (MRI) demonstrates high accuracy for invasive breast cancer, its diagnostic value for precancerous lesions remains uncertain - particularly in average-risk screening populations. This study aimed to assess the diagnostic performance of an abbreviated breast MRI reading protocol in a screening-like cohort. **Patients and methods:** In this prospective single-center study, 58 women (mean age 58±24 years) with 59 suspicious MC on full-field digital mammography (FFDM) were included. A total of 68 lesions underwent histopathological verification. MRI datasets were independently assessed by four radiologists (5-15 years of experience), blinded to mammographic findings, using a standardized abbreviated protocol including maximum intensity projection (MIP), early post-contrast subtraction, and native images. **Results:** Among 59 microcalcification lesions, 21 were malignant and 38 benign. Sensitivity ranged from 74% to 83%, specificity from 58% to 83%, positive predictive value from 56% to 75%, negative predictive value from 83% to 86%, and accuracy from 68% to 81%. No invasive carcinomas were missed by any reader. False-negative findings were exclusively ductal carcinoma _in situ_ (DCIS). Mean reading time ranged from 1 min 42 sec to 3 min 26 s. MIP-only evaluation demonstrated markedly lower sensitivity (48-52%) despite higher specificity (83-94%). Interreader agreement for the final recall decision was moderate (Fleiss' κ=0.47), with pairwise Cohen's κ values ranging from 0.40 to 0.53. **Conclusion:** Abbreviated breast MRI is a feasible and time-efficient approach with consistent diagnostic performance across readers for evaluating suspicious MC, further evaluation as screening tool is needed. MIP-only evaluation, does not appear to provide sufficient diagnostic reliability. **Keywords:** Breast MRI; breast cancer screening; ductal carcinoma in situ; microcalcifications. Copyright © 2026 International Institute of Anticancer Research (Dr. George J. Delinas
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