Is Magnetic Resonance Imaging (MRI) Still a Gold Standard to DetectBreast Cancer: A Meta-analysis

Purpose: Breast cancer is fatal if it is not diagnosed and treated promptly; consequently, early and precise diagnosis is essential. In comparison to mammography and sonography, the sensitivity of MRI to cellular changes and its ability to differentiate benign from malignant tumors make it the preferred imaging technique. Consequently, the present meta-analysis assessed the effectiveness of different imaging modalities for breast cancer detection and evaluated the diagnostic accuracy of MRI. Methods: Pertinent articles were searched in PubMed, MEDLINE, and Central databases using the appropriate keywords as per the PRISMA guidelines. Retrospective and prospective studies were included according to the predefined PICOS criteria. A meta-analysis was performed using RevMan and MedCalc software, and statistical parameters, such as odds ratio, sensitivity, specificity, likelihood ratios, and accuracy, were calculated. Publication bias was evaluated using Egger’s and Begg’s tests, and diagnostic performance was assessed using Youden’s and Bland-Altman's plots. Results: Fourteen clinical trials with 4666 breast cancer patients with perineural spread were included. The included studies used MRI for the detection of breast cancer lesions according to the BI-RADS® (Breast Imaging Reporting and Data System) guidelines and stated that it has high sensitivity and diagnostic accuracy. Similarly, the present meta-analysis found a high sensitivity of 86.12 % and a high diagnostic accuracy of 91.2%. Other than this, we obtained a specificity of 65%, a positive likelihood ratio of 2.7, and a negative likelihood ratio of 0.22. The pooled odds ratio (OR) was reported to be 1.87 (95% CI 1.42-2.46), and the pooled risk ratio value was 1.19 (95% CI 1.11-1.28). Conclusion: Present meta-analysis strongly recommends MRI as an effective imaging method for the detection of breast cancer.