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MR Imaging of the Ipsilateral Breast in Women with Percutaneously Proven Breast Cancer

¹ Breast Imaging Section, Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.
² Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY10021.

View larger version (96K): [in a new window]   Fig. 1A. —34-year-old woman with palpable lump in upper outer quadrant of left breast. Mediolateral oblique left mammogram shows density (arrow) in left upper outer quadrant adjacent to radiopaque skin marker denoting palpable lump.

View larger version (172K): [in a new window]   Fig. 1B. —34-year-old woman with palpable lump in upper outer quadrant of left breast. Sonogram of left breast shows hypoechoic solid mass (arrows) measuring 2 cm that corresponds to palpable lump. Sonographically guided core biopsy yielded infiltrating ductal carcinoma.

View larger version (132K): [in a new window]   Fig. 1C. —34-year-old woman with palpable lump in upper outer quadrant of left breast. Sagittal T1-weighted contrast-enhanced MR image of left breast shows irregular multilobulated, rim-enhancing mass (straight arrow) corresponding to index cancer adjacent to vitamin E marker denoting palpable lump with extensive adjacent clumped segmental enhancement (curved arrows).

View larger version (135K): [in a new window]   Fig. 1D. —34-year-old woman with palpable lump in upper outer quadrant of left breast. Sagittal T1-weighted contrast-enhanced MR image of left breast approximately 1 cm medial to C shows that segmental clumped enhancement (curved arrows) extends anteriorly and posteriorly to index cancer (straight arrow), with entire extent of MR imaging abnormality spanning approximately 6.8 cm. Mastectomy revealed infiltrating ductal carcinoma and extensive ductal carcinoma in situ with axillary metastases.

View larger version (76K): [in a new window]   Fig. 2A. —42-year-old woman with palpable lump in upper outer quadrant of right breast. Craniocaudal right mammogram shows irregular spiculated mass (arrow) in right upper outer quadrant that corresponds to palpable lump. Sonographically guided core biopsy yielded infiltrating ductal carcinoma and ductal carcinoma in situ (DCIS).

View larger version (121K): [in a new window]   Fig. 2B. —42-year-old woman with palpable lump in upper outer quadrant of right breast. Sagittal T1-weighted contrast-enhanced MR image of right breast shows irregular spiculated heterogeneously enhancing mass (straight arrow) corresponding to index cancer, with additional irregular spiculated mass (curved arrow) approximately 1.4 cm inferiorly.

View larger version (126K): [in a new window]   Fig. 2C. —42-year-old woman with palpable lump in upper outer quadrant of right breast. Sagittal T1-weighted contrast-enhanced MR image of right breast approximately 6 mm lateral to B shows extensive segmental clumped enhancement (arrows) spanning approximately 5.5 cm and extending from index cancer toward nipple. Wide surgical excision yielded multifocal infiltrating mammary carcinoma with mixed ductal and lobular features and DCIS, with tumor at resection margins and axillary metastases. Residual infiltrating mammary carcinoma with ductal and lobular features and DCIS was found at mastectomy.

View larger version (92K): [in a new window]   Fig. 3A. —78-year-old woman with palpable lump in upper outer quadrant of right breast. Craniocaudal right mammogram shows irregular spiculated mass (arrow) that corresponds to palpable lump in right upper outer quadrant.

View larger version (114K): [in a new window]   Fig. 3B. —78-year-old woman with palpable lump in upper outer quadrant of right breast. Sonogram of right breast shows irregular hypoechoic solid mass (arrows) in upper outer quadrant of right breast that corresponds to palpable and mammographic mass. Sonographically guided core biopsy showed infiltrating lobular carcinoma.

View larger version (121K): [in a new window]   Fig. 3C. —78-year-old woman with palpable lump in upper outer quadrant of right breast. Sagittal contrast-enhanced T1-weighted MR image of right breast shows irregular spiculated heterogeneously enhancing mass (arrows) in right upper outer quadrant corresponding to index cancer.

View larger version (137K): [in a new window]   Fig. 3D. —78-year-old woman with palpable lump in upper outer quadrant of right breast. Sagittal contrast-enhanced T1-weighted MR image of right breast shows additional irregularly shaped, irregularly marginated, heterogeneously enhancing masses (arrows) in right upper inner and lower inner quadrants. Mastectomy revealed infiltrating lobular carcinoma in right upper outer, upper inner, and lower inner quadrants and axillary metastases.

View larger version (98K): [in a new window]   Fig. 4A. —47-year-old asymptomatic woman with abnormal findings at mammography. Magnified 90° lateral left mammogram shows 0.4-cm cluster of pleomorphic calcifications (arrow) in lower inner quadrant of left breast. Stereotactic biopsy yielded ductal carcinoma in situ (DCIS).

View larger version (59K): [in a new window]   Fig. 4B. —47-year-old asymptomatic woman with abnormal findings at mammography. Mediolateral oblique left mammogram obtained after stereotactic biopsy shows air and localizing clip (arrow) at biopsy site and no residual calcifications.

View larger version (116K): [in a new window]   Fig. 4C. —47-year-old asymptomatic woman with abnormal findings at mammography. Sagittal T1-weighted contrast-enhanced MR image of left breast shows localizing clip (open arrow) evident as signal void and adjacent clumped linear and ductal enhancement (solid arrows) in left lower inner quadrant.

View larger version (122K): [in a new window]   Fig. 4D. —47-year-old asymptomatic woman with abnormal findings at mammography. Sagittal T1-weighted contrast-enhanced MR image of left breast shows separate irregularly shaped, irregularly marginated, heterogeneously enhancing mass (arrow) in left breast at 6:00-o'clock position.

View larger version (115K): [in a new window]   Fig. 4E. —47-year-old asymptomatic woman with abnormal findings at mammography. Sagittal T1-weighted contrast-enhanced MR image of left breast with vitamin E marker placed over skin entry site from stereotactic biopsy shows irregularly shaped, irregularly marginated, heterogeneously enhancing mass (arrow) in lower outer quadrant of left breast. MR imaging–guided needle localization was performed of this mass and of mass at 6:00-o'clock position (shown in D), and mammographically guided needle localization was performed of clip. All sites yielded DCIS, solid and cribriform type, intermediate nuclear grade. Residual DCIS was found at mastectomy.

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