{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:22:47Z","timestamp":1772252567405,"version":"3.50.1"},"reference-count":52,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T00:00:00Z","timestamp":1631059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","award":["RF-2009-1539582"],"award-info":[{"award-number":["RF-2009-1539582"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>In women at high\/intermediate lifetime risk of breast cancer (BC-LTR), contrast-enhanced magnetic resonance imaging (MRI) added to mammography \u00b1 ultrasound (MX \u00b1 US) increases sensitivity but decreases specificity. Screening with MRI alone is an alternative and potentially more cost-effective strategy. Here, we describe the study protocol and the characteristics of enrolled patients for MRIB feasibility, multicenter, randomized, controlled trial, which aims to compare MRI alone versus MX+US in women at intermediate breast cancer risk (aged 40\u201359, with a 15\u201330% BC-LTR and\/or extremely dense breasts). Two screening rounds per woman were planned in ten centers experienced in MRI screening, the primary endpoint being the rate of cancers detected in the 2 arms after 5 years of follow-up. From July 2013 to November 2015, 1254 women (mean age 47 years) were enrolled: 624 were assigned to MX+US and 630 to MRI. Most of them were aged below 50 (72%) and premenopausal (45%), and 52% used oral contraceptives. Among postmenopausal women, 15% had used hormone replacement therapy. Breast and\/or ovarian cancer in mothers and\/or sisters were reported by 37% of enrolled women, 79% had extremely dense breasts, and 41% had a 15\u201330% BC-LTR. The distribution of the major determinants of breast cancer risk profiles (breast density and family history of breast and ovarian cancer) of enrolled women varied across centers.<\/jats:p>","DOI":"10.3390\/diagnostics11091635","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T02:41:07Z","timestamp":1631068867000},"page":"1635","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["MRI versus Mammography plus Ultrasound in Women at Intermediate Breast Cancer Risk: Study Design and Protocol of the MRIB Multicenter, Randomized, Controlled Trial"],"prefix":"10.3390","volume":"11","author":[{"given":"Luigina Ada","family":"Bonelli","sequence":"first","affiliation":[{"name":"Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Calabrese","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Belli","sequence":"additional","affiliation":[{"name":"Department of Radiological, Radiotherapic and Hematological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Corcione","sequence":"additional","affiliation":[{"name":"Breast Imaging Unit, Arcispedale Sant\u2019Anna, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Losio","sequence":"additional","affiliation":[{"name":"Unit of Senology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Montemezzi","sequence":"additional","affiliation":[{"name":"Unit of Radiology BT, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1432-2137","authenticated-orcid":false,"given":"Federica","family":"Pediconi","sequence":"additional","affiliation":[{"name":"Department of Radiological, Oncological and Pathological Sciences, Universit\u00e0 degli Studi \u201cLa Sapienza\u201d, 00161 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2465-5370","authenticated-orcid":false,"given":"Antonella","family":"Petrillo","sequence":"additional","affiliation":[{"name":"Radiology Unit, Istituto Nazionale dei Tumori IRCCS Fondazione G. Pascale, 80131 Napoli, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Zuiani","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Azienda Ospedaliera Universitaria \u201cSanta Maria della Misericordia\u201d, Universit\u00e0 degli Studi di Udine, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Camera","sequence":"additional","affiliation":[{"name":"Unit of Radiology BT, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca Alessandro","family":"Carbonaro","sequence":"additional","affiliation":[{"name":"Unit of Radiology, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy"},{"name":"Department of Radiology, Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy"},{"name":"Department of Oncology and Hemato-Oncology, Universit\u00e0 degli Studi di Milano, 20122 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4922-7065","authenticated-orcid":false,"given":"Andrea","family":"Cozzi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"De Falco Alfano","sequence":"additional","affiliation":[{"name":"Breast Imaging Unit, Arcispedale Sant\u2019Anna, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy"},{"name":"Mammography Center, Radiology Unit, Policlinico Sant\u2019Orsola\u2013Malpighi, 40138 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Licia","family":"Gristina","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Panzeri","sequence":"additional","affiliation":[{"name":"Unit of Senology, IRCCS Ospedale San Raffaele, 20132 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaria","family":"Poir\u00e8","sequence":"additional","affiliation":[{"name":"Unit of Clinical Epidemiology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4243-888X","authenticated-orcid":false,"given":"Simone","family":"Schiaffino","sequence":"additional","affiliation":[{"name":"Unit of Radiology, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Tosto","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanna","family":"Trecate","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rubina Manuela","family":"Trimboli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"},{"name":"Breast Imaging and Screening Unit, Department of Radiology, Humanitas Clinical and Research Center\u2014IRCCS, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Valdora","sequence":"additional","affiliation":[{"name":"Unit of Diagnostic Senology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Vigan\u00f2","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6545-9427","authenticated-orcid":false,"given":"Francesco","family":"Sardanelli","sequence":"additional","affiliation":[{"name":"Unit of Radiology, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy"},{"name":"Department of Biomedical Sciences for Health, Universit\u00e0 degli Studi di Milano, 20133 Milano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"g3701","DOI":"10.1136\/bmj.g3701","article-title":"Modern mammography screening and breast cancer mortality: Population study","volume":"348","author":"Romundstad","year":"2014","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/s13244-020-00905-3","article-title":"Do we still need breast cancer screening in the era of targeted therapies and precision medicine?","volume":"11","author":"Trimboli","year":"2020","journal-title":"Insights Imaging"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1056\/NEJMsr1504363","article-title":"Breast-Cancer Screening\u2014Viewpoint of the IARC Working Group","volume":"372","author":"Scoccianti","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1177\/0969141318816736","article-title":"Breast cancer subtype and screening sensitivity in the Quebec Mammography Screening Program","volume":"26","author":"Perron","year":"2019","journal-title":"J. Med. Screen."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1001\/jamaoncol.2016.6326","article-title":"Population-Attributable Risk Proportion of Clinical Risk Factors for Breast Cancer","volume":"3","author":"Engmann","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/s10549-017-4274-9","article-title":"Mammographic breast density and breast cancer risk in a Mediterranean population: A nested case\u2013control study in the EPIC Florence cohort","volume":"164","author":"Masala","year":"2017","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1186\/s13058-014-0417-7","article-title":"Mammographic features associated with interval breast cancers in screening programs","volume":"16","author":"Boyd","year":"2014","journal-title":"Breast Cancer Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"673","DOI":"10.7326\/M14-1465","article-title":"Identifying Women with Dense Breasts at High Risk for Interval Cancer","volume":"162","author":"Kerlikowske","year":"2015","journal-title":"Ann. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1002\/ijc.32731","article-title":"Interval breast cancer risk associations with breast density, family history and breast tissue aging","volume":"147","author":"Nguyen","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1148\/radiol.2018172119","article-title":"Digital Mammography versus Digital Mammography Plus Tomosynthesis for Breast Cancer Screening: The Reggio Emilia Tomosynthesis Randomized Trial","volume":"288","author":"Pattacini","year":"2018","journal-title":"Radiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1148\/radiol.2016161444","article-title":"Supplemental Breast MR Imaging Screening of Women with Average Risk of Breast Cancer","volume":"283","author":"Kuhl","year":"2017","journal-title":"Radiology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.21037\/qims.2019.11.09","article-title":"The emerging role of contrast-enhanced mammography","volume":"9","author":"Cozzi","year":"2019","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1038\/s41568-019-0142-8","article-title":"Cancer overdiagnosis: A biological challenge and clinical dilemma","volume":"19","author":"Srivastava","year":"2019","journal-title":"Nat. Rev. Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1200\/JCO.2009.23.0839","article-title":"Prospective Multicenter Cohort Study to Refine Management Recommendations for Women at Elevated Familial Risk of Breast Cancer: The EVA Trial","volume":"28","author":"Kuhl","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1097\/RLI.0b013e3181f3fcdf","article-title":"Multicenter Surveillance of Women at High Genetic Breast Cancer Risk Using Mammography, Ultrasonography, and Contrast-Enhanced Magnetic Resonance Imaging (the High Breast Cancer Risk Italian 1 Study)","volume":"46","author":"Sardanelli","year":"2011","journal-title":"Investigative Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1001\/jama.2012.388","article-title":"Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk","volume":"307","author":"Berg","year":"2012","journal-title":"JAMA"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1200\/JCO.2014.56.8626","article-title":"Triple-Modality Screening Trial for Familial Breast Cancer Underlines the Importance of Magnetic Resonance Imaging and Questions the Role of Mammography and Ultrasound Regardless of Patient Mutation Status, Age, and Breast Density","volume":"33","author":"Riedl","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1186\/s13058-018-1019-6","article-title":"The added value of mammography in different age-groups of women with and without BRCA mutation screened with breast MRI","volume":"20","author":"Vreemann","year":"2018","journal-title":"Breast Cancer Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1148\/radiol.2016151419","article-title":"Breast Cancers Detected at Screening MR Imaging and Mammography in Patients at High Risk: Method of Detection Reflects Tumor Histopathologic Results","volume":"280","author":"Sung","year":"2016","journal-title":"Radiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1001\/jamainternmed.2018.8372","article-title":"Performance of Screening Ultrasonography as an Adjunct to Screening Mammography in Women across the Spectrum of Breast Cancer Risk","volume":"179","author":"Lee","year":"2019","journal-title":"JAMA Intern. Med."},{"key":"ref_21","unstructured":"National Comprehensive Cancer Network (2021). NCCN Guidelines Version 1.2021 Breast Cancer Screening and Diagnosis, National Comprehensive Cancer Network."},{"key":"ref_22","unstructured":"National Institute for Health and Care Excellence (NICE) (2021, June 14). Familial Breast Cancer: Classification, Care and Managing Breast Cancer and Related Risks in People with a Family History of Breast Cancer. Available online: https:\/\/www.nice.org.uk\/guidance\/cg164\/chapter\/Recommendations."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13053-017-0064-y","article-title":"Screening with magnetic resonance imaging, mammography and ultrasound in women at average and intermediate risk of breast cancer","volume":"15","author":"Huzarski","year":"2017","journal-title":"Hered. Cancer Clin. Pract."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1056\/NEJMoa1903986","article-title":"Supplemental MRI Screening for Women with Extremely Dense Breast Tissue","volume":"381","author":"Bakker","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1016\/j.ejca.2010.02.015","article-title":"Magnetic resonance imaging of the breast: Recommendations from the EUSOMA working group","volume":"46","author":"Sardanelli","year":"2010","journal-title":"Eur. J. Cancer"},{"key":"ref_26","unstructured":"D\u2019Orsi, C.J., Sickles, E.A., Mendelson, E.B., and Morris, E.A. (2013). ACR BI-RADS\u00ae Atlas, Breast Imaging Reporting and Data System, American College of Radiology. [5th ed.]."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.clbc.2019.01.006","article-title":"The Global and Regional Survival Rate of Women with Breast Cancer: A Systematic Review and Meta-analysis","volume":"19","author":"Maajani","year":"2019","journal-title":"Clin. Breast Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2401","DOI":"10.21037\/qims-2020-26","article-title":"Breast cancer screening: In the era of personalized medicine, age is just a number","volume":"10","author":"Cozzi","year":"2020","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/j.ejca.2010.12.002","article-title":"Evidence of the effect of adjunct ultrasound screening in women with mammography-negative dense breasts: Interval breast cancers at 1-year follow-up","volume":"47","author":"Corsetti","year":"2011","journal-title":"Eur. J. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1038\/s41416-018-0080-3","article-title":"Addition of ultrasound to mammography in the case of dense breast tissue: Systematic review and meta-analysis","volume":"118","author":"Rebolj","year":"2018","journal-title":"Br. J. Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"268","DOI":"10.7326\/M15-1789","article-title":"Supplemental Screening for Breast Cancer in Women with Dense Breasts: A Systematic Review for the U.S. Preventive Services Task Force","volume":"164","author":"Melnikow","year":"2016","journal-title":"Ann. Intern. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1200\/JCO.2013.52.8331","article-title":"Effectiveness of Screening with Annual Magnetic Resonance Imaging and Mammography: Results of the Initial Screen from the Ontario High Risk Breast Screening Program","volume":"32","author":"Chiarelli","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1148\/radiol.2017161103","article-title":"Evaluation of the Utility of Screening Mammography for High-Risk Women Undergoing Screening Breast MR Imaging","volume":"285","author":"Lo","year":"2017","journal-title":"Radiology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"324","DOI":"10.2214\/AJR.19.21988","article-title":"Gadolinium Retention and Breast MRI Screening: More Harm Than Good?","volume":"214","author":"Sardanelli","year":"2020","journal-title":"Am. J. Roentgenol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/jmri.26654","article-title":"Contrast-enhanced MRI for breast cancer screening","volume":"50","author":"Mann","year":"2019","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1148\/radiol.2541090953","article-title":"Reasons Women at Elevated Risk of Breast Cancer Refuse Breast MR Imaging Screening: ACRIN 6666","volume":"254","author":"Berg","year":"2010","journal-title":"Radiology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e216","DOI":"10.1002\/jmri.26334","article-title":"Breast MRI screening for average-risk women: A monte carlo simulation cost\u2013benefit analysis","volume":"49","author":"Mango","year":"2019","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1001\/jamaoncol.2020.2922","article-title":"Cost-effectiveness of Breast Cancer Screening with Magnetic Resonance Imaging for Women at Familial Risk","volume":"6","author":"Geuzinge","year":"2020","journal-title":"JAMA Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2304","DOI":"10.1200\/JCO.2013.52.5386","article-title":"Abbreviated Breast Magnetic Resonance Imaging (MRI): First Postcontrast Subtracted Images and Maximum-Intensity Projection\u2014A Novel Approach to Breast Cancer Screening with MRI","volume":"32","author":"Kuhl","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"284","DOI":"10.2214\/AJR.16.17205","article-title":"Abbreviated MRI Protocols: Wave of the Future for Breast Cancer Screening","volume":"208","author":"Chhor","year":"2017","journal-title":"Am. J. Roentgenol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.clinimag.2018.10.017","article-title":"Abbreviated protocol breast MRI: The past, present, and future","volume":"53","author":"Greenwood","year":"2019","journal-title":"Clin. Imaging"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1258\/jms.2012.012078","article-title":"The Impact of Mammographic Screening on Breast Cancer Mortality in Europe: A Review of Observational Studies","volume":"19","author":"Broeders","year":"2012","journal-title":"J. Med. Screen."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jclinepi.2016.07.016","article-title":"A systematic review of discontinued trials suggested that most reasons for recruitment failure were preventable","volume":"80","author":"Briel","year":"2016","journal-title":"J. Clin. Epidemiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s10549-010-1064-z","article-title":"A practical approach to manage additional lesions at preoperative breast MRI in patients eligible for breast conserving therapy: Results","volume":"124","author":"Elshof","year":"2010","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"108976","DOI":"10.1016\/j.ejrad.2020.108976","article-title":"Can second-look ultrasound downgrade MRI-detected lesions? A retrospective study","volume":"127","author":"Kolta","year":"2020","journal-title":"Eur. J. Radiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ejrad.2019.02.008","article-title":"Can we predict lesion detection rates in second-look ultrasound of MRI-detected breast lesions? A systematic analysis","volume":"113","author":"Bumberger","year":"2019","journal-title":"Eur. J. Radiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1093\/jnci\/djaa140","article-title":"Breast Cancer Screening Trials: Endpoints and Overdiagnosis","volume":"113","author":"Jatoi","year":"2020","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1177\/0284185118770918","article-title":"Motion artifacts, lesion type, and parenchymal enhancement in breast MRI: What does really influence diagnostic accuracy?","volume":"60","author":"Clauser","year":"2019","journal-title":"Acta Radiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.ejrad.2019.02.018","article-title":"Breast MRI background parenchymal enhancement as an imaging bridge to molecular cancer sub-type","volume":"113","author":"Dilorenzo","year":"2019","journal-title":"Eur. J. Radiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/jmri.26762","article-title":"Background parenchymal enhancement on breast MRI: A comprehensive review","volume":"51","author":"Liao","year":"2020","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1007\/s00330-018-5765-8","article-title":"Six-year prospective evaluation of second-look US with volume navigation for MRI-detected additional breast lesions","volume":"29","author":"Fausto","year":"2019","journal-title":"Eur. Radiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Den Dekker, B.M., Bakker, M.F., de Lange, S.V., Veldhuis, W.B., van Diest, P.J., Duvivier, K.M., Lobbes, M.B.I., Loo, C.E., Mann, R.M., and Monninkhof, E.M. (2021). Reducing False-Positive Screening MRI Rate in Women with Extremely Dense Breasts Using Prediction Models Based on Data from the DENSE Trial. Radiology.","DOI":"10.1148\/radiol.2021210325"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/9\/1635\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:58:25Z","timestamp":1760165905000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/9\/1635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,8]]},"references-count":52,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["diagnostics11091635"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11091635","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2021.03.10.21253341","asserted-by":"object"}]},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,8]]}}}