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Journal of Breast Cancer Research

ISSN: 2769-2418

Original Research Open Access

Accuracy of breast MRI for cancer diagnosis: correlation with BI-RADS and biopsy findings

Mustafa S. Alghazzawi1,*, Eman A. Al-Kamil2, Mustafa S Yousuf3, Thair S. Abdulla4, Bakhos Alhaddad5
  • 1Department of Radiology, Al-Ahli Hospital, Qatar, Doha
  • 2Department of Pharmacology, Public Health and Clinical Skill, Faculty of Medicine, Hashemite University, Zarqa, Jordan
  • 3Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, Hashemite University, Zarqa, Jordan
  • 4Department of Radiology, Al-Ahli Hospital, Qatar, Doha
  • 5Department of surgery, Al-Ahli Hospital, Qatar, Doha
+ Affiliations - Affiliations

Corresponding Author

Mustafa S. Alghazzawi, mustafaalghazzawi1984@gmail.com

Received Date: April 17, 2026

Accepted Date: May 19, 2026

Citation:

Alghazzawi MS, Al-Kamil EA, Yousuf MS, Abdulla TS, Alhaddad B. Accuracy of breast MRI for cancer diagnosis: correlation with BI-RADS and biopsy findings. J Breast Cancer Res. 2026;6(1):53-57.


Copyright: © 2026 Alghazzawi MS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Breast cancer remains a major global health concern, and early detection is essential for improving treatment outcomes. Breast magnetic resonance imaging (MRI), incorporating advanced multiparametric techniques, offers detailed morphological and functional assessment that enhances lesion characterization. Evaluating the diagnostic performance of MRI in comparison with histopathology is important for understanding its clinical utility.

Objectives: This study aims to evaluate the diagnostic performance of breast MRI at Al-Ahli Hospital and assess the agreement between MRI-based BI-RADS categories and biopsy results.

Methodology: A retrospective analysis was conducted on female patients who underwent breast MRI between October 2022 and October 2025. Among 394 MRI examinations, 109 patients also underwent mammography and subsequent biopsy, enabling direct correlation between imaging findings and histopathology. MRI interpretations utilized standardized BI-RADS criteria. Statistical analyses included chi square testing, Spearman correlation, and calculation of sensitivity, specificity, PPV, and NPV.

Results: Of the 109 patients included, MRI demonstrated excellent sensitivity for malignancy detection at 100% (95% CI: 83.2–100%) and a negative predictive value (NPV) of 100% (95% CI: 90.5–100%). Specificity was lower at 41.6% (95% CI: 31.3–52.5%), reflecting overlap between benign and malignant enhancement patterns, while the positive predictive value (PPV) was 27.8% (95% CI: 18.0–39.6%). Overall diagnostic accuracy was 52.3% (95% CI: 42.5–62.0%). Tumor size showed a significant positive correlation with malignant MRI assessment. BI-RADS categorization demonstrated significant association with biopsy outcomes.

Discussion: Breast MRI showed outstanding sensitivity, in line with international literature, reaffirming its strength in ruling out malignancy when results are negative. However, the comparatively lower specificity reflects common interpretive challenges, particularly with benign enhancing lesions. These findings emphasize the importance of integrating MRI with mammography, ultrasound, clinical data, and histopathology rather than using MRI as an isolated diagnostic tool. BI RADS scoring remains a valuable framework, but interobserver variability and overlapping enhancement patterns warrant careful multidisciplinary review.

Conclusion: Breast MRI provides exceptional diagnostic sensitivity and NPV within the studied population and serves as a powerful component of multimodal breast imaging. Nonetheless, due to reduced specificity, MRI findings should be interpreted in conjunction with other imaging and pathological assessments to optimize diagnostic accuracy and patient management.

Keywords

Breast MRI, BI-RADS, Breast cancer, Diagnostic performance, Histopathology, Multiparametric MRI

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