Enhancing area surrounding breast carcinoma on MR mammography: comparison with pathological examination

Goethem, M. Van; Schelfout, Katrien; Kersschot, E.; Colpaert, Cécile; Verslegers, I.; Biltjes, I.; Tjalma, Wiebren A.A.; Weyler, Joost; Schepper, A. De

doi:10.1007/s00330-004-2295-3

Cited by 43 publications

(24 citation statements)

References 14 publications

(15 reference statements)

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“…In retrospect, only the relatively high signal intensity within the lesion found on the precontrast scan may be taken as a hint as to its aetiology and fat content. This feature, which has also been described in fat necrosis, was confirmed with the specific fat-suppressed technique [9][10][11].…”

Section: Discussionsupporting

confidence: 69%

Lupus panniculitis involving the breast

et al. 2005

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Lupus panniculitis is an unusual immunological disease that characteristically affects the subcutaneous fat and occurs in 2% of patients with systemic lupus erythematosus. We report a case of lupus panniculitis involving the breast, which represents a very uncommon location. Mammographically, it presented as a suspicious irregular mass involving the subcutaneous fat pad with skin thickening. High echogenicity constituted the most relevant sonographic finding. To the best of our knowledge, the magnetic resonance (MR) features have not been previously described. High signal intensity was found on both T1- and T2-weighted precontrast MR images. A dynamic contrast-enhanced study revealed a suspicious focal mass with irregular margins and rim enhancement, with a type 3 time-signal intensity curve. Differential diagnosis with carcinoma and fat necrosis and the value of core biopsy are discussed.

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Section: Discussionsupporting

confidence: 69%

Lupus panniculitis involving the breast

et al. 2005

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“…Dynamic enhancement rates of DCIS are extremely variable [16], but morphological criteria such as segmental or linear enhancement have been reported to be the imaging hallmarks of DCIS on breast MRI [15,[17][18][19][20][21][22][23]. However, the positive predictive value of this enhancement pattern is still unknown.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI

et al. 2005

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The aim of this study was the evaluation of the diagnostic usefulness of ductal or segmental enhancement in dynamic breast MRI. Segmental and ductal enhancement have been established as the breast MRI hallmarks of intraductal breast cancer (DCIS); however, the positive predictive value of this imaging finding is still unknown. In our study, we analysed the overall prevalence of a segmental or a linear enhancement pattern on breast MRI for an unselected cohort of patients. The aim was to evaluate the diagnostic usefulness of segmental or linear enhancement. Second, we asked whether biopsy was necessary also in the absence of mammographic findings suggestive of DCIS. Prospective, consecutive evaluation of 1,003 patients undergoing bilateral dynamic breast MRI. Studies were interpreted by two experienced breast radiologists. A diagnostic or screening two-view mammogram was available for all patients. Biopsy or short-term breast MRI follow-up was recommended for patients showing a segmental or a linear enhancement pattern on breast MRI. The patients' final diagnoses were established by imaging guided excisional or core biopsy or by clinical plus conventional imaging follow-up for a period of 2 years. The prevalence of segmental or linear enhancement was determined for patients with a final diagnosis of benign breast disease compared with those with a diagnosis of breast cancer. One hundred twenty patients had invasive breast cancer, 24 patients had DCIS and 859 patients had unsuspicious breast MRI or benign breast disease. A segmental or a linear enhancement pattern was found for 50/1,003 (5%) patients (17 DCIS, 33 benign breast diseases). Accordingly, the positive predictive value of segmental and linear enhancement is 34% (17/50); the specificity of this criterion is 96% (826/859). For 4/24 (17%) patients, DCIS was visible as segmental or linear enhancement on dynamic breast MRI, whereas no abnormalities were visible on the corresponding mammogram. The overall prevalence of a ductal or a segmental enhancement pattern on breast MRI is low. But this finding has a high specificity and a moderate positive predictive value for intraductal neoplastic changes. We conclude that if segmental or linear enhancement is identified on breast MRI further work-up is necessary. We recommend either direct MR-guided vacuum-assisted core biopsy or short-term follow-up breast MRI within 3 months. If ductal enhancement then persists, MR-guided biopsy should be recommended even in the absence of mammographically visible signs of DCIS.

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“…Magnetic resonance imaging (MRI) has a high sensitivity for invasive cancer [13,14] and is reported to be more accurate in defining multinodular disease than conventional imaging, both in the ipsilateral and the contralateral breast [15][16][17][18][19][20][21][22][23][24][25][26][27][28]. MRI detects multinodular disease in 16-38% of patients with breast cancer in whom palpation and conventional imaging only shows a unifocal tumor.…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced MRI in breast cancer patients eligible for breast-conserving therapy: complementary value for subgroups of patients

et al. 2005

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The aim of this study was to identify patients prior to breast-conserving therapy (BCT) who have complementary value of contrast-enhanced magnetic resonance imaging (MRI) over conventional imaging in the assessment of tumor extent. All patients were eligible for BCT according to conventional imaging, and underwent preoperative MRI as part of this study. One hundred and sixty-five patients (166 tumors) were included. MRI was defined to have complementary value if conventional imaging underestimated or overestimated tumor extent (by more than 10 mm compared to histology) and MRI assessed the extent accurately. Logistic regression was employed to identify characteristics that are predictive of the complementary value of preoperative MRI. MRI had complementary value in 39 cases (23%). Patients <58 years old with irregular lesion margins at mammography and discrepancy in tumor extent by more than 10 mm between mammography and ultrasonography had a 3.2x higher chance of accurate assessment at MRI (positive predictive value 50%, negative predictive value 84%, p=0.0002). Preoperative MRI in patients eligible for BCT is more accurate than conventional imaging in the assessment of tumor extent in approximately one out of four patients. Subgroups of patients in whom MRI has complementary value may be defined by the differences in clinical and imaging features.

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Enhancing area surrounding breast carcinoma on MR mammography: comparison with pathological examination

Cited by 43 publications

References 14 publications

Lupus panniculitis involving the breast

Lupus panniculitis involving the breast

Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI

Contrast-enhanced MRI in breast cancer patients eligible for breast-conserving therapy: complementary value for subgroups of patients

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