Chronic Hematoma Mimicing Recurrent Breast Carcinoma and Contribution of Magnetic Resonance Imaging to the Diagnosis

Abstract

Local recurrence of breast carcinoma after breast conservative therapy is an unwanted situation with a high possibility. Paranchymal distortion and edema secondary to surgery and radiotheraphy results in difficulties in the mammographic and ultrasonographic evaluation of the breast. After treatment of breast carcinoma, sensitivity of mammography decreases below the normal population. Breast magnetic resonance imaging (MRI) can be helpful in the discrimination of scar tissue in the region of operation from local recurrence. Advanced MRI applications such as diffusion weighted imaging (DWI) and proton ( 1 H) MR spectroscopy also have contribution in diagnosis. In this case report we aimed to determine the contribution of MRI and advanced MRI techniques to a lesion which was detected by conventional methods in an operated breast carcinoma patient.Key words: Breast cancer, diffusion weighted imaging, hematoma, magnetic resonance imaging, proton magnetic resonance spectroscopy ÖZETMeme kanserinin lokal rekürrensi meme koruyucu tedavi sonrası istenmeyen ve büyük olasılığı olan bir durumdur. Parankimal distorsiyon, cerrahiye sekonder ödem ve radyoterapi mammografik ve ultrasonografik değerlen-dirimi zorlaştırır. Meme karsinomunun tedavisi sonrası, mammografinin sensitivitesi normal popülasyonun altındadır. Meme manyetik rezonans görüntüleme (MRG), operasyon alanında skar dokusunun ayrımında yardımcı olabilir. Difüzyon ağırlıklı görüntüleme (DAG) ve proton ( 1 H) manyetik rezonans (MR) spektroskopi gibi ileri MRG uygulamalarının da tanıya katkısı vardır. Bu olgu sunumunda, MRG ve ileri MRG tekniklerinin konvansiyonel yöntemlerle opere meme karsinomlu bir hastada saptanan bir lezyonun tanıya katkısının değerlendirmeyi amaçladık.Anahtar sözcükler: Meme kanseri, difüzyon manyetik rezonans, hematom, manyetik rezonans görüntüleme, proton manyetik rezonans görüntüleme IntroductionRecurrence of disease at locoregional and distant sites occurs frequently in women who have undergone primary treatment for breast cancer. Locoregional recurrence occurs in up to 35% of patients by 10 years after mastectomy or breast-conserving therapy (1). Mammography is less sensitive in the treated breast than in the untreated breast due to surgery and radiation-induced changes in the parenchymal pattern (2). Magnetic resonance imaging (MRI) is a very useful method in diagnosis of breast lesions which cannot be characterized by mammography, ultrasonography (US) and physical examination (3). Advanced MRI applications such as diffusion weighted imaging (DWI) and proton ( 1 H) magnetic resonance (MR) spectroscopy also have contribution in diagnosis (4, 5).In this case report we aimed to determine the contribution of MRI and advanced MRI techniques (DWI and single voxel 1 H MR spectroscopy) to a lesion which was detected by conventional methods in an operated breast carcinoma patient. Case ReportA 67-year-old patient with the diagnosis of invasive ductal carcinoma was evaluated in her third post-operative year, after breast conservation therap...