MR Imaging-Guided Sonography Followed by Fine-Needle Aspiration Cytology in Occult Carcinoma of the Breast
Inge-Marie A. Obdeijn1,
Elise M. J. Brouwers-Kuyper1,
Madeleine M. A. Tilanus-Linthorst1,
Theodore Wiggers2 and
Matthijs Oudkerk1
1
Department of Radiology, Dr. Daniel den Hoed Cancer Center, University
Hospital Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam, the
Netherlands.
2
Department of Surgery, Dr. Daniel den Hoed Cancer Center, University Hospital
Rotterdam, 3075 EA Rotterdam, the Netherlands.
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Fig. 1A. —47-year-old woman who underwent right-sided mastectomy for breast
cancer. Six years later, metastatic lymph node was palpable in contralateral
axilla and was only abnormal finding on clinical examination and mammography.
Histopathologic examination (not shown) revealed infiltrative ductal
carcinoma. Oblique (A) and craniocaudal (B) mammograms of left
breast show enlarged, dense lymph node (arrow, A) as only
abnormality.
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Fig. 1B. —47-year-old woman who underwent right-sided mastectomy for breast
cancer. Six years later, metastatic lymph node was palpable in contralateral
axilla and was only abnormal finding on clinical examination and mammography.
Histopathologic examination (not shown) revealed infiltrative ductal
carcinoma. Oblique (A) and craniocaudal (B) mammograms of left
breast show enlarged, dense lymph node (arrow, A) as only
abnormality.
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Fig. 1C. —47-year-old woman who underwent right-sided mastectomy for breast
cancer. Six years later, metastatic lymph node was palpable in contralateral
axilla and was only abnormal finding on clinical examination and mammography.
Histopathologic examination (not shown) revealed infiltrative ductal
carcinoma. Unenhanced (C), contrast-enhanced (D), and
subtraction (E) MR images reveal small lesion (arrows) in
medial area of left breast, suggestive of second primary breast cancer.
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Fig. 1D. —47-year-old woman who underwent right-sided mastectomy for breast
cancer. Six years later, metastatic lymph node was palpable in contralateral
axilla and was only abnormal finding on clinical examination and mammography.
Histopathologic examination (not shown) revealed infiltrative ductal
carcinoma. Unenhanced (C), contrast-enhanced (D), and
subtraction (E) MR images reveal small lesion (arrows) in
medial area of left breast, suggestive of second primary breast cancer.
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Fig. 1E. —47-year-old woman who underwent right-sided mastectomy for breast
cancer. Six years later, metastatic lymph node was palpable in contralateral
axilla and was only abnormal finding on clinical examination and mammography.
Histopathologic examination (not shown) revealed infiltrative ductal
carcinoma. Unenhanced (C), contrast-enhanced (D), and
subtraction (E) MR images reveal small lesion (arrows) in
medial area of left breast, suggestive of second primary breast cancer.
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Fig. 1F. —47-year-old woman who underwent right-sided mastectomy for breast
cancer. Six years later, metastatic lymph node was palpable in contralateral
axilla and was only abnormal finding on clinical examination and mammography.
Histopathologic examination (not shown) revealed infiltrative ductal
carcinoma. Sonogram shows lesion (calipers) in left breast.
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Fig. 2A. —45-year-old woman with lymph node containing metastases of
adenocarcinoma in left axilla. Histopathologic examination (not shown)
revealed infiltrative ductal carcinoma. Oblique (A) and craniocaudal
(B) mammograms of left breast show metastatic tumor in axillary lymph
node (arrow, A). No suspicious lesions are seen in breast
tissue.
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Fig. 2B. —45-year-old woman with lymph node containing metastases of
adenocarcinoma in left axilla. Histopathologic examination (not shown)
revealed infiltrative ductal carcinoma. Oblique (A) and craniocaudal
(B) mammograms of left breast show metastatic tumor in axillary lymph
node (arrow, A). No suspicious lesions are seen in breast
tissue.
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Fig. 2C. —45-year-old woman with lymph node containing metastases of
adenocarcinoma in left axilla. Histopathologic examination (not shown)
revealed infiltrative ductal carcinoma. Unenhanced (C),
contrast-enhanced (D), and subtracted (E) MR images show small
enhancing lesion (arrows, D and E) in lateral area of
left breast.
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Fig. 2D. —45-year-old woman with lymph node containing metastases of
adenocarcinoma in left axilla. Histopathologic examination (not shown)
revealed infiltrative ductal carcinoma. Unenhanced (C),
contrast-enhanced (D), and subtracted (E) MR images show small
enhancing lesion (arrows, D and E) in lateral area of
left breast.
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Fig. 2E. —45-year-old woman with lymph node containing metastases of
adenocarcinoma in left axilla. Histopathologic examination (not shown)
revealed infiltrative ductal carcinoma. Unenhanced (C),
contrast-enhanced (D), and subtracted (E) MR images show small
enhancing lesion (arrows, D and E) in lateral area of
left breast.
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Fig. 2F. —45-year-old woman with lymph node containing metastases of
adenocarcinoma in left axilla. Histopathologic examination (not shown)
revealed infiltrative ductal carcinoma. MR imaging-guided sonogram shows 8-mm
lesion (arrow). Small solid lesion has no sonographic criteria
typical of malignancy and would be easily missed without previous MR
imaging.
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Copyright © 2000 by the American Roentgen Ray Society.
