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MR Imaging Findings in the Contralateral Breast of Women with Recently Diagnosed Breast Cancer

¹ Breast Imaging Section, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.
² Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.

View larger version (76K): [in a new window]   Fig. 1A. —61-year-old woman whose recent core biopsy of palpable lump in right upper outer quadrant yielded infiltrating lobular carcinoma. Mammogram (not shown) revealed moderately dense breasts without suspicious findings. Sagittal T1-weighted contrast-enhanced MR image of right (ipsilateral) breast shows irregularly shaped, irregularly marginated, heterogeneously enhancing mass (arrow) in upper outer quadrant measuring 2.4 cm at maximal diameter, corresponding to palpable cancer.

View larger version (69K): [in a new window]   Fig. 1B. —61-year-old woman whose recent core biopsy of palpable lump in right upper outer quadrant yielded infiltrating lobular carcinoma. Mammogram (not shown) revealed moderately dense breasts without suspicious findings. Sagittal T1-weighted contrast-enhanced MR image of left (contralateral) breast shows irregularly shaped, irregularly marginated, heterogeneously enhancing mass (arrow) in left upper outer quadrant measuring 1.6 cm at maximal diameter. MR imaging—guided needle localization showed multifocal infiltrating carcinoma with mixed lobular and ductal features.

View larger version (92K): [in a new window]   Fig. 2A. —63-year-old woman 2 years after excision of ductal carcinoma in situ (DCIS) in left upper outer quadrant. Mammogram (not shown) revealed moderately dense breasts with two spiculated masses in left breast at 3:00 and 5:00 axes. Sonography-guided core biopsy yielded infiltrating mammary carcinoma with ductal and lobular features from both sites. Sagittal T1-weighted contrast-enhanced MR image of left (ipsilateral) breast shows signal void from clips at lumpectomy site (open arrow). Corresponding to core biopsy—proven carcinoma are two irregular spiculated masses (solid arrows) with heterogeneous enhancement in left 3:00 axis measuring 1.3 cm and in left 5:00 axis measuring 2.2 cm, with clumped linear enhancement extending between and anterior to masses.

View larger version (82K): [in a new window]   Fig. 2B. —63-year-old woman 2 years after excision of ductal carcinoma in situ (DCIS) in left upper outer quadrant. Mammogram (not shown) revealed moderately dense breasts with two spiculated masses in left breast at 3:00 and 5:00 axes. Sonography-guided core biopsy yielded infiltrating mammary carcinoma with ductal and lobular features from both sites. Sagittal T1-weighted contrast-enhanced MR image of right (contralateral) breast shows irregular, spiculated heterogeneously enhancing mass (arrow) measuring 1.3 cm. Sonography-guided core biopsy (not shown) yielded infiltrating mammary carcinoma with ductal and lobular features and DCIS.

View larger version (124K): [in a new window]   Fig. 3A. —47-year-old woman with palpable lump in right upper outer quadrant for which core biopsy revealed infiltrating ductal carcinoma and ductal carcinoma in situ (DCIS). Mammogram (not shown) revealed moderately dense breasts without suspicious findings. Sagittal T1-weighted contrast-enhanced MR image of right (ipsilateral) breast shows irregularly shaped, irregularly marginated, heterogeneously enhancing masses (arrows) spanning 3.2 cm in upper outer quadrant, corresponding to palpable cancer.

View larger version (117K): [in a new window]   Fig. 3B. —47-year-old woman with palpable lump in right upper outer quadrant for which core biopsy revealed infiltrating ductal carcinoma and ductal carcinoma in situ (DCIS). Mammogram (not shown) revealed moderately dense breasts without suspicious findings. Sagittal T1-weighted contrast-enhanced MR image of left (contralateral) breast shows clumped linear enhancement (arrow) spanning 1.6 cm in 12:00 axis. MR imaging—guided needle localization yielded DCIS.

View larger version (99K): [in a new window]   Fig. 4A. —66-year-old woman after core biopsy of palpable mass in right upper outer quadrant yielded infiltrating lobular carcinoma and in situ carcinoma with mixed ductal and lobular features. Mammogram (not shown) revealed mildly dense breasts with irregular spiculated mass in right upper outer quadrant. Sagittal T1-weighted contrast-enhanced MR image of right (ipsilateral) breast showed irregular, spiculated, heterogeneously enhancing mass (arrow) in right upper outer quadrant measuring 2.5 cm, corresponding to palpable cancer.

View larger version (88K): [in a new window]   Fig. 4B. —66-year-old woman after core biopsy of palpable mass in right upper outer quadrant yielded infiltrating lobular carcinoma and in situ carcinoma with mixed ductal and lobular features. Mammogram (not shown) revealed mildly dense breasts with irregular spiculated mass in right upper outer quadrant. Sagittal T1-weighted contrast-enhanced MR image of left (contralateral) breast shows irregularly shaped, irregularly marginated, heterogeneously enhancing mass (arrow) measuring 0.6 cm in left upper outer quadrant. MR imaging—guided needle localization (not shown) yielded ductal carcinoma in situ.

View larger version (79K): [in a new window]   Fig. 5A. —34 year-old woman with palpable mass in upper outer quadrant of right breast in whom core biopsy yielded ductal carcinoma in situ (DCIS). Mammogram (not shown) revealed moderately dense breasts and irregular, spiculated mass with pleomorphic calcifications in right upper outer quadrant. Sagittal T1-weighted contrast-enhanced MR image of right (ipsilateral) breast shows irregular, spiculated, heterogeneously enhancing mass measuring 4.2 cm, corresponding to palpable cancer. Extensive residual DCIS was found at mastectomy.

View larger version (83K): [in a new window]   Fig. 5B. —34 year-old woman with palpable mass in upper outer quadrant of right breast in whom core biopsy yielded ductal carcinoma in situ (DCIS). Mammogram (not shown) revealed moderately dense breasts and irregular, spiculated mass with pleomorphic calcifications in right upper outer quadrant. Sagittal T1-weighted contrast-enhanced MR image of left (contralateral) breast shows irregularly shaped, irregularly marginated, heterogeneously enhancing 1.5 cm mass (arrow) in upper outer quadrant. MR imaging—guided needle localization (not shown) yielded proliferative fibrocystic change. Patient chose to undergo prophylactic left mastectomy during same procedure, which revealed no evidence of carcinoma.

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