EUROPEAN JOURNAL OF RADIOLOGY, cilt.165, ss.110864, 2023 (SCI-Expanded)
Purpose: To investigate the factors associated with false-negative results in the diagnosis of
breast cancer via breast magnetic resonance imaging (MRI) using the Kaiser score (KS).
Methods: This institutional review board (IRB)-approved, single-center, retrospective study
enrolled 219 consecutive histopathologically proven breast cancer lesions in 205 women who
underwent preoperative breast MRI. Two breast radiologists evaluated each lesion according
to the KS. The clinicopathological characteristics and imaging findings were also analyzed.
Interobserver variability was assessed using the intraclass correlation coefficient (ICC).
Multivariate regression analysis was used to investigate factors associated with false-negative
KS results for breast cancer diagnosis.
Results: Of 219 breast cancers, KS yielded 200 (91.3%) true-positive and 19 (8.7%) falsenegative results. The interobserver ICC for the KS between the two readers was excellent,
with a value of 0.804 (95% CI 0.751–0.846). Multivariate regression analysis revealed that
small lesion size (≤1 cm) (adjusted OR 6.86, 95% CI 2.14–21.94, p=0.001) and personal
breast cancer history (adjusted OR 7.59, 95% CI, 1.55–37.23, p=0.012) were significantly
associated with false-negative KS results.
Conclusion: Small lesion size (≤1 cm) and presence of personal breast cancer history are
factors significantly associated with false-negative KS results. Our results suggest that
radiologists should consider these factors in clinical practice as potential pitfalls of KS, which
may be compensated for by a multimodal approach combined with clinical evaluation.