Inflammatory carcinoma of the breast: Characteristic findings of MR imaging

Abstract

Inflammatory breast carcinoma (IBC) Shows a unique clinical appearance and has an extremely poor prognosis. Although immediate intensive therapy has been proposed, diagnosis of this disease tends to be delayed as its clinical features can be confused with acute mastitis. The conventional imaging modalities including mammography and ultrasonography are of limited value in the diagnosis of IBC, as it is difficult to delineate specific findings of the swollen dense breast. Recently, magnetic resonance (MR) imaging has been widely applied to breast diseases. One of the excellent features of this modality is its diagnostic ability in dense breasts. However, few trials to evaluate the capability of this new modality for IBC have been documented. In recent years, we found that a characteristic feature in 5 cases of IBC was a strong signal on T2-weighted images (T2WI) of MR imaging at the retromammary and subcutaneous area. Pathological features of the retromammary area showed marked interstitial edema and focal lymphatic involvement by tumor cells. These characteristic images obtained by MR imaging may be suggestive of inflammatroy breast carcinoma. Furthermore, subtracted dynamic MR imaging indicated the site of the tumor. Therefore, the application of MR imaging for swollen breasts would assist in the immediate diagnosis of IBC and would contribute to appropriate and timely therapy.

Is evaluation of the presence of prepectoral edema on T2-weighted with fat-suppression 3 T breast MRI a simple and readily available noninvasive technique for estimation of prognosis in patients with breast cancer?

“…Results were based on data Breast Cancer (2014) 21:684-692 685 extracted from this clinical database and included detailed imaging characteristics of lesions according to the BI-RADS MRI lexicon [19], presence of prepectoral edema as high SI on T2WI [14][15][16][17], and histopathological results. On T2WI, the presence or absence of prepectoral edema, defined as SI similar to that of water, in the area in front of the pectoral muscle, was assessed (Figs.…”

“…On T2WI, the presence or absence of prepectoral edema, defined as SI similar to that of water, in the area in front of the pectoral muscle, was assessed (Figs. 1, 2) [14][15][16][17]. Visual analysis of the time course of enhancement in the three dynamic phases in the axial plane was performed, and findings were categorized according to the BI-RADS MRI lexicon [19].…”

“…Prepectoral edema can be particularly valuable because it is a very important MRI finding for inflammatory breast cancer (IBC) [14][15][16][17]. Several reports have indicated that prepectoral edema is a specific MRI finding of IBC [14][15][16][17], although prepectoral edema is also observed for some locally advanced breast cancers and acute mastitis [15,16].…”

Inflammatory breast cancer: MR imaging findings

“…In questa serie, la diagnosi di invasione neoplastica dei vasi 78 Radiol med (2010) 115:70-82 antibiotic treatment [4,[15][16][17]. MR imaging has taken on an increasingly important role in the management of breast cancer, and its indications now include initial diagnosis, staging of known cancer, monitoring the effects of neoadjuvant chemotherapy and the diagnosis of disease recurrence.…”

“…All'indagine mammografcia ed ecografica, lesioni espansive e microcalcificazioni sono rare manifestazioni di questa patologia e gli unici aspetti suggestivi di un sottostante carcinoma sono rappresentati dalla presenza di isolati reperti infiammatori (ispessimento cutaneo, diffuso incremento della densità, ispessimento della trabecolatura stromale, linfoadenopatia ascellare) e dalla mancata risposta alla terapia antibiotica [4,[15][16][17].…”