Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Oncology Letters
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-1074 Online ISSN: 1792-1082
Journal Cover
June-2026 Volume 31 Issue 6

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
June-2026 Volume 31 Issue 6

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article Open Access

Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI

  • Authors:
    • Tara Farooq Kareem
    • Areege Mustafa Kamal
    • Munawar Al Nakash
  • View Affiliations / Copyright

    Affiliations: Department of Surgery, College of Medicine, University of Baghdad, Baghdad 89WG+GX, Iraq, Department of Pathology, Oncology Teaching Hospital, Medical City, Baghdad 89WH+9MF, Iraq
    Copyright: © Kareem et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 212
    |
    Published online on: April 2, 2026
       https://doi.org/10.3892/ol.2026.15567
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:


Abstract

Identifying malignant non‑mass enhancement (NME) in contrast‑enhanced breast magnetic resonance imaging (MRI) remains a notable diagnostic challenge due to overlapping imaging features between benign and malignant lesions. Although the delayed‑phase kinetic patterns are well‑established, the diagnostic value of the initial‑phase kinetics has not been fully elucidated. The present study aimed to evaluate the dynamic and morphological characteristics of NME lesions, to determine whether incorporating initial‑phase kinetics with delayed‑phase analysis improves the discrimination between benign and malignant cases. A prospective study was conducted at the Oncology Teaching Hospital (Baghdad, Iraq) from April to December 2022, including patients referred for breast MRI. Only cases with pure NME (without associated mass lesions) were included. A core biopsy was performed for all cases, with excisional biopsy when indicated. Data collection followed the Breast Imaging Reporting and Data System 5th edition criteria. Among 38 enrolled patients (mean age, 45±11.45 years; range, 26‑75 years; median, 44 years), 63.2% presented with a breast lump and 26.3% underwent screening. Histopathology confirmed malignancy in 26 cases (68.4%), comprising 12 cases of ductal carcinoma in situ and 14 of invasive ductal carcinoma. Segmental enhancement was the most common malignant pattern [positive predictive value (PPV), 83.3%], followed by regional enhancement (PPV, 64.3%). Benign lesions had slow (58.3%) or medium (41.7%) initial upslopes, whereas 50% of malignant tumors exhibited a rapid initial slope (P=0.001). Persistent delay was observed in 75% of benign cases but in only 26.9% of malignant cases (P=0.005). Integrating the initial upslope with the plateau‑phase kinetics increased the PPV for malignancy from 75 to 81.8%. In conclusion, the integration of initial‑phase kinetics with traditional delayed‑phase and morphological assessment improves the diagnostic accuracy for malignant NME lesions. This multi‑parametric approach could potentially serve as a valuable tool to reduce the rate of unnecessary biopsies in the future.
View Figures

Figure 1

Representative histology of breast
lesions associated with dynamic curve types: (A) Fibrocystic
changes associated with Type I curve with an initial medium rise
(50–100%), (B) extensive intermediate grade ductal carcinoma in
situ associated with Type I curve with an initial medium rise
(50–100%) and (C) invasive ductal carcinoma associated with Type
III curve with rapid initial rise (>100%). Hematoxylin and eosin
staining; magnification, ×100, scale bar is 200 µm.

Figure 2

Dynamic contrast study of three women
with histopathology-confirmed ductal carcinoma in situ,
demonstrating a Type I curve with varying initial phases. (A) A
50-year-old woman with a palpable left breast lesion, MRI shows
non-mass enhancement with green and red labels representing the
region of interest (ROI), (B) Time intensity curve exhibited a Type
I curve with an initial moderate rise (50–100%). (C) A 45-year-old
woman with a palpable left lump, MRI shows non-mass enhancement
with red label representing the region of interest (ROI). (D) Time
intensity curve exhibited a Type I curve with a slow initial rise
(<50%). (E) A 65-year-old woman with a palpable right lump. (F)
Time intensity curve exhibited a Type I curve with a slow initial
rise (<50%). Type I, persistent.

Figure 3

Dynamic contrast study of three women
exhibiting a Type II curve with different initial phases. (A) A
27-year-old woman with a palpable left lump, MRI shows non-mass
enhancement with red label representing the region of interest. (B)
Time intensity curve displayed a Type II curve with an initial
moderate rise (50–100%). Histopathology confirmed granulomatous
mastitis. (C) A 36-year-old woman with a left breast lump, MRI
shows non-mass enhancement with green and red labels representing
the region of interest (ROI), (D) Time intensity curve exhibited a
Type II curve with a rapid initial rise (>100%), diagnosed as
DCIS on excision. (E) A 75-year-old woman with a left breast lump,
MRI shows non-mass enhancement, (F) Time intensity curve
demonstrated a Type II curve with an initial moderate rise
(50–100%), confirmed as DCIS upon excision. DCIS, ductal carcinoma
in situ; Type II, plateau.

Figure 4

Dynamic contrast study of three women
exhibiting a Type III curve with different initial phases. (A) A
57-year-old woman with a right breast lump, MRI shows non-mass
enhancement with green label representing the region of interest
(ROI), (B) Time intensity curve demonstrated a Type III curve with
a rapid initial rise (>100%). Histopathology confirmed DCIS with
invasive ductal carcinoma. (C) A 50-year-old woman with a palpable
breast lump. MRI shows non-mass enhancement with red labels
representing the region of interest (ROI), (D) Time intensity curve
exhibited a Type III curve with a rapid initial rise (>100%),
diagnosed as DCIS without invasive components on excision. (E) A
36-year-old woman with a right breast lump. (F) Time intensity
curve exhibited a Type III curve with a rapid initial rise
(>100%). Core biopsy revealed invasive ductal carcinoma. DCIS,
ductal carcinoma in situ; Type III, washout.
View References

1 

Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I and Jemal A: Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 74:229–263. 2024.PubMed/NCBI

2 

Sree SV, Ng EY, Acharya RU and Faust O: Breast imaging: A survey. World J Clin Oncol. 2:171–178. 2011. View Article : Google Scholar : PubMed/NCBI

3 

Wekking D, Porcu M, De Silva P, Saba L, Scartozzi M and Solinas C: Breast MRI: clinical indications, recommendations, and future applications in breast cancer diagnosis. Curr Oncol Rep. 25:257–267. 2023. View Article : Google Scholar : PubMed/NCBI

4 

Gargiulo M, Dien E, Gal J, Schiappa R, Elkind L and Lamarque M: Predictive factors for non-mass enhancement occult in conventional breast imaging: The ‘PAMAS’ study. Eur J Radiol. 184:1119622025. View Article : Google Scholar : PubMed/NCBI

5 

Mohamed S, Elhamd EA and Attia NM: Non-mass enhancement on breast MRI: Clues to a more confident diagnosis. Egypt J Radiol Nucl Med. 55:872024. View Article : Google Scholar

6 

Spak DA, Plaxco JS, Santiago L, Dryden MJ and Dogan BE: BI-RADS® fifth edition: A summary of changes. Diagn Interv Imaging. 98:179–190. 2017. View Article : Google Scholar : PubMed/NCBI

7 

Cheng L, Bai Y, Zhang J, Liu M, Li X, Zhang A, Zhang X and Ma L: Optimization of apparent diffusion coefficient measured by diffusion-weighted MRI for diagnosis of breast lesions presenting as mass and non-mass-like enhancement. Tumour Biol. 34:1537–1545. 2013. View Article : Google Scholar : PubMed/NCBI

8 

Yang QX, Ji X, Feng LL, Zheng L, Zhou XQ, Wu Q and Chen X: Significant MRI indicators of malignancy for breast non-mass enhancement. J Xray Sci Technol. 25:1033–1044. 2017.PubMed/NCBI

9 

Liu G, Li Y, Chen SL and Chen Q: Non-mass enhancement breast lesions: MRI findings and associations with malignancy. Ann Transl Med. 10:3572022. View Article : Google Scholar : PubMed/NCBI

10 

Aydin H: The MRI characteristics of non-mass enhancement lesions of the breast: Associations with malignancy. Br J Radiol. 92:201804642019. View Article : Google Scholar : PubMed/NCBI

11 

Zhou J, Li M, Liu D, Sheng F and Cai J: Differential diagnosis of benign and malignant breast papillary neoplasms on MRI with non-mass enhancement. Acad Radiol. 30 (Suppl 2):S127–S32. 2023. View Article : Google Scholar : PubMed/NCBI

12 

D'Orsi C, Sickles E, Mendelson E and Morris EA: ACR BI-RADS Atlas: Breast Imaging Reporting and Data System. American College of Radiology; Reston, VA: 2013

13 

Cheng L and Li X: Breast magnetic resonance imaging: Kinetic curve assessment. Gland Surg. 2:50–53. 2013.PubMed/NCBI

14 

Asada T, Yamada T, Kanemaki Y, Fujiwara K, Okamoto S and Nakajima Y: Grading system to categorize breast MRI using BI-RADS 5th edition: A statistical study of non-mass enhancement descriptors in terms of probability of malignancy. Jpn J Radiol. 36:200–208. 2018. View Article : Google Scholar : PubMed/NCBI

15 

Yoon GY, Choi WJ, Cha JH, Shin HJ, Chae EY and Kim HH: The role of MRI and clinicopathologic features in predicting the invasive component of biopsy-confirmed ductal carcinoma in situ. BMC Med Imaging. 20:952020. View Article : Google Scholar : PubMed/NCBI

16 

Bluemke DA, Gatsonis CA, Chen MH, DeAngelis GA, DeBruhl N, Harms S, Heywang-Köbrunner SH, Hylton N, Kuhl CK, Lehman C, et al: Magnetic resonance imaging of the breast prior to biopsy. JAMA. 292:2735–2742. 2004. View Article : Google Scholar : PubMed/NCBI

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Kareem TF, Kamal AM and Al Nakash M: Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI. Oncol Lett 31: 212, 2026.
APA
Kareem, T.F., Kamal, A.M., & Al Nakash, M. (2026). Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI. Oncology Letters, 31, 212. https://doi.org/10.3892/ol.2026.15567
MLA
Kareem, T. F., Kamal, A. M., Al Nakash, M."Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI". Oncology Letters 31.6 (2026): 212.
Chicago
Kareem, T. F., Kamal, A. M., Al Nakash, M."Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI". Oncology Letters 31, no. 6 (2026): 212. https://doi.org/10.3892/ol.2026.15567
Copy and paste a formatted citation
x
Spandidos Publications style
Kareem TF, Kamal AM and Al Nakash M: Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI. Oncol Lett 31: 212, 2026.
APA
Kareem, T.F., Kamal, A.M., & Al Nakash, M. (2026). Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI. Oncology Letters, 31, 212. https://doi.org/10.3892/ol.2026.15567
MLA
Kareem, T. F., Kamal, A. M., Al Nakash, M."Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI". Oncology Letters 31.6 (2026): 212.
Chicago
Kareem, T. F., Kamal, A. M., Al Nakash, M."Dynamic curve type serves as an effective tool for the diagnosis of benign or malignant non‑mass enhancements on breast MRI". Oncology Letters 31, no. 6 (2026): 212. https://doi.org/10.3892/ol.2026.15567
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team