Morphological and Dynamic Contrast-Enhanced MRI Characteristics of Benign and Malignant Breast Lesions: A Prospective Observational Study

Background: Accurate differentiation between benign and malignant breast lesions is crucial for appropriate patient management. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provides both morphological and functional information that enhances lesion characterization beyond conventional imaging modalities. Aim: To evaluate the morphological and dynamic contrast-enhanced MRI characteristics of benign and malignant breast lesions. Materials and Methods: This prospective observational study included 40 patients with suspected breast lesions who underwent breast MRI using a dedicated breast coil. Lesions were assessed for morphological features and dynamic contrast enhancement patterns. MRI findings were correlated with histopathological diagnosis, which served as the reference standard. Statistical analysis was performed to determine the diagnostic performance of MRI. Results: Malignant lesions were significantly associated with older age, larger lesion size, axillary lymph node involvement, and higher BI-RADS MRI categories (p < 0.05). Morphological features such as irregular shape, spiculated margins, heterogeneous enhancement, T2 hypointensity, and rim enhancement were strongly predictive of malignancy. Dynamic analysis revealed that malignant lesions predominantly exhibited early rapid enhancement and Type III (washout) kinetic curves, while benign lesions showed Type I (persistent) enhancement. Combined morphological and kinetic assessment demonstrated high sensitivity (90.9%), specificity (83.3%), and overall diagnostic accuracy (87.5%), with an AUC of 0.92. Conclusion: Breast MRI, using a combined approach of morphological assessment and dynamic contrast-enhanced kinetic analysis, provides excellent diagnostic accuracy in differentiating benign from malignant breast lesions and serves as a valuable adjunct in breast imaging.