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AJR 2004; 183:1805-1809
© American Roentgen Ray Society

Contrast-Enhanced High-Resolution MRI of Invasive Breast Cancer: Correlation with Histopathologic Subtypes

Kakuya Kitagawa1, Hajime Sakuma1, Nanaka Ishida1, Tadanori Hirano2, Akinori Ishihara3 and Kan Takeda1

1 Department of Radiology, Mie University, School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
2 Department of Radiology, Matsusaka Central Hospital, 102 Kobo Kawaimachi, Matsusaka, Mie 515-8566, Japan.
3 Department of Pathology, Matsusaka Central Hospital, Mie 515-8566, Japan.

OBJECTIVE. We sought to determine whether contrast-enhanced MRI could aid in the identification of the histopathologic subtypes of invasive ductal carcinoma.

MATERIALS AND METHODS. We evaluated the contrast-enhanced MR images obtained in 62 women with invasive ductal carcinoma of no special type. The presence or absence of three distinct MRI findings—linear enhancement, a serrated border, and delayed rim enhancement—was evaluated. Classification and regression tree analyses were performed to construct the most efficient algorithm for predicting histopathologic subtype on the basis of dynamic MRI features.

RESULTS. Histopathologic subtypes of the invasive ductal carcinomas were scirrhous carcinoma in 22 patients, solid tubular carcinoma in 14, and papillotubular carcinoma in 26. A lesion with a serrated border was observed in 28 (45.2%) of the 62 patients. Delayed rim enhancement was seen in 23 (37.1%) and linear enhancement in 20 (32.3%). Scirrhous carcinomas were closely associated with a serrated border (20/22 or 90.9%, p < 0.0001). Delayed rim enhancement was frequently observed in solid tubular carcinomas (12/14 or 85.7%, p < 0.0001) but was not typically seen in scirrhous carcinomas (1/22 or 4.5%, p < 0.0001). Linear enhancement showed relatively high prevalence in papillotubular carcinomas (13/26 or 50%) and low prevalence in solid tubular carcinomas (1/22 or 7%, p < 0.02). Histopathologic subtypes of invasive breast carcinoma of no special type could be correctly identified in 47 (75.8%) of 62 lesions using the diagnostic algorithm generated by the classification and regression tree analyses.

CONCLUSION. MRI features showed a close relationship with histopathologic subtypes of invasive ductal carcinoma of no special type. Contrast-enhanced MRI can be a noninvasive diagnostic tool for histopathologic subtypes of invasive breast cancer.


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