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Preoperative Assessment of Breast Cancer: Sonography Versus MR Imaging

¹ Department of Radiology, Johannes Gutenberg University Hospital, Langenbeckstr. 1, 55131 Mainz, Germany.
² Department of Gynecology, Johannes Gutenberg University Hospital, 55131 Mainz, Germany.

View larger version (90K): [in a new window]   Fig. 1A. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Craniocaudal mammogram of left breast shows round mass (arrows) with smooth borders that appears to be benign.

View larger version (139K): [in a new window]   Fig. 1B. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Sonogram of lesion in left breast reveals hypoechoic lesion (large arrow) with solid internal structure (small arrow), suggestive of papilloma or intracystic carcinoma that requires biopsy.

View larger version (110K): [in a new window]   Fig. 1C. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Unenhanced T1-weighted MR image depicts lesion (arrow) in left breast.

View larger version (106K): [in a new window]   Fig. 1D. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Contrast-enhanced T1-weighted MR image depicts lesion (arrow) in left breast.

View larger version (125K): [in a new window]   Fig. 1E. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Digital subtraction MR image (corresponding to C and D) shows strongly enhancing round lesion (arrow), falsely suggesting carcinoma. Final histologic diagnosis was papilloma.

View larger version (112K): [in a new window]   Fig. 1F. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Unenhanced T1-weighted MR image shows right breast.

View larger version (118K): [in a new window]   Fig. 1G. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Contrast-enhanced T1-weighted MR image shows right breast.

View larger version (96K): [in a new window]   Fig. 1H. —77-year-old woman with diffuse ductal carcinoma of right breast and suspected bilateral cancer. Digital subtraction MR image (corresponding to F and G) reveals diffuse, growing tumor (arrows) with relatively weak enhancement.

View larger version (105K): [in a new window]   Fig. 2A. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was made after sonography and was confirmed after MR imaging. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Bilateral mediolateral mammogram shows asymmetric inhomogeneous tissue with architectural distortion (arrows) in right breast, suggesting diffuse disease.

View larger version (166K): [in a new window]   Fig. 2B. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was made after sonography and was confirmed after MR imaging. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Sonogram of right breast shows suspicious 5.9-mm hypoechoic lesion (arrow) with irregular borders. Four identical lesions were identified within range of 4 cm. Because of disseminated tumor in relatively small breast, mastectomy was recommended.

View larger version (118K): [in a new window]   Fig. 2C. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Unenhanced T1-weighted MR image depicts right breast.

View larger version (120K): [in a new window]   Fig. 2D. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Contrast-enhanced T1-weighted MR image of right breast was obtained at same level as C.

View larger version (106K): [in a new window]   Fig. 2E. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Digital subtraction MR image of right breast (corresponding to C and D) shows disseminated lesions (arrows).

View larger version (113K): [in a new window]   Fig. 2F. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Unenhanced T1-weighted MR image of right breast was obtained at level subsequent to level of C—E.

View larger version (120K): [in a new window]   Fig. 2G. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Contrast-enhanced T1-weighted MR image of right breast was obtained at same level as F.

View larger version (112K): [in a new window]   Fig. 2H. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Digital subtraction MR image of right breast (corresponding to F and G) shows disseminated lesions (arrows).

View larger version (132K): [in a new window]   Fig. 2I. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Unenhanced T1-weighted MR image of right breast obtained at level subsequent to level of F—H shows full extent of tumor.

View larger version (126K): [in a new window]   Fig. 2J. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Contrast-enhanced T1-weighted MR image of right breast was obtained at same level as I.

View larger version (136K): [in a new window]   Fig. 2K. —44-year-old woman with multifocal mixed tubular—lobular carcinoma of right breast. Recommendation for mastectomy was confirmed. Histology found disseminated small invasive foci within extensive lobular carcinoma in situ. Digital subtraction MR image of right breast (corresponding to I and J) reveals multiple disseminated foci (arrow).

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