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Ductal Enhancement on MR Imaging of the Breast

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

View larger version (77K): [in a new window]   Fig. 1A. —Asymptomatic 40-year-old woman who had undergone left lumpectomy 5 years earlier. Sagittal contrast-enhanced T1-weighted MR image of left breast shows heterogeneous ductal enhancement in upper outer quadrant (arrow).

View larger version (143K): [in a new window]   Fig. 1B. —Asymptomatic 40-year-old woman who had undergone left lumpectomy 5 years earlier. Photomicrograph of histopathologic specimen obtained at MR imaging–guided needle localization and surgical biopsy shows ductal carcinoma in situ of high nuclear grade, with minimal necrosis, involving several ducts. (H and E, x40)

View larger version (79K): [in a new window]   Fig. 2. —Asymptomatic 50-year-old woman who had undergone right lumpectomy 5 years earlier. Sagittal contrast-enhanced T1-weighted MR image of left breast shows clips from prior lumpectomy in upper outer quadrant (open arrows) and clumped ductal enhancement in lower outer quadrant (solid arrow). MR imaging–guided needle localization and surgical excision yielded ductal carcinoma in situ with cribriform growth pattern.

View larger version (101K): [in a new window]   Fig. 3. —Asymptomatic 48-year-old woman who had undergone left lumpectomy 3 years earlier. Collimated sagittal contrast-enhanced T1-weighted MR image of left breast shows clumped ductal branching enhancement in upper inner quadrant (arrow). MR imaging–guided needle localization and surgical excision yielded ductal carcinoma in situ, papillary and cribriform types.

View larger version (94K): [in a new window]   Fig. 4A. —Asymptomatic 47-year-old woman who had undergone right lumpectomy 5 months previously. Sagittal contrast-enhanced T1-weighted MR image of the left breast shows heterogeneous ductal enhancement in lower inner quadrant (arrow).

View larger version (134K): [in a new window]   Fig. 4B. —Asymptomatic 47-year-old woman who had undergone right lumpectomy 5 months previously. Photomicrograph of histopathologic specimen from MR imaging–guided needle localization and surgical excision shows a cluster of cysts with apocrine metaplasia surrounded by fibrosis, consistent with fibrocystic change. (H and E, x20)

View larger version (104K): [in a new window]   Fig. 5A. —Asymptomatic 42-year-old woman with family history of breast cancer. Sagittal contrast-enhanced T1-weighted MR image of left breast reveals clumped ductal enhancement in upper outer quadrant (arrow).

View larger version (173K): [in a new window]   Fig. 5B. —Asymptomatic 42-year-old woman with family history of breast cancer. Photomicrograph of histopathologic specimen from MR imaging–guided needle localization shows breast tissue with stromal fibrosis. (H and E, x40)

View larger version (89K): [in a new window]   Fig. 6A. —Asymptomatic 55-year-old woman who had undergone left lumpectomy 3 years earlier. Sagittal contrast-enhanced T1-weighted MR image of left breast shows heterogeneous ductal enhancement in retroareolar region (arrow).

View larger version (162K): [in a new window]   Fig. 6B. —Asymptomatic 55-year-old woman who had undergone left lumpectomy 3 years earlier. Photomicrograph of histopathologic specimen from MR imaging–guided needle localization and surgical excision shows mammary duct ectasia with minimal ductal hyperplasia. (H and E, x20)

View larger version (92K): [in a new window]   Fig. 7A. —Asymptomatic 43-year-old woman who had undergone left mastectomy 7 months earlier. Sagittal T1-weighted contrast-enhanced MR image of left breast shows clumped ductal enhancement in lower inner quadrant (arrows).

View larger version (203K): [in a new window]   Fig. 7B. —Asymptomatic 43-year-old woman who had undergone left mastectomy 7 months earlier. Photomicrograph of histopathologic specimen from MR imaging–guided needle localization and surgical biopsy of central portion of lesion shows mammary duct ectasia and atypical ductal hyperplasia. (H and E, x100)

View larger version (109K): [in a new window]   Fig. 8A. —Asymptomatic 60-year-old woman who had undergone right lumpectomy 6 weeks earlier. Sagittal T1-weighted contrast-enhanced MR image of left breast shows clumped ductal enhancement in lower outer quadrant spanning 1.0 cm (arrow).

View larger version (169K): [in a new window]   Fig. 8B. —Asymptomatic 60-year-old woman who had undergone right lumpectomy 6 weeks earlier. Photomicrograph of histopathologic specimen from MR imaging–guided needle localization and surgical excision shows lobular carcinoma in situ in small ducts. (H and E, x100)

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