AJR
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Teifke, A.
Right arrow Articles by Thelen, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Teifke, A.
Right arrow Articles by Thelen, M.
Social Bookmarking
 Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Outcome Analysis and Rational Management of Enhancing Lesions Incidentally Detected on Contrast-Enhanced MRI of the Breast

Andrea Teifke1, Hans Anton Lehr2, Toni Werner Vomweg1, Alexander Hlawatsch1 and Manfred Thelen1

1 Department of Radiology, Johannes Gutenberg University of Mainz, Langenbeckstr. 1, Mainz D-55131, Germany.
2 Department of Pathology, Johannes Gutenberg University of Mainz, Mainz D-55131, Germany.



View larger version (184K):

[in a new window]
 
Fig. 1A. Enhancing incidental lesion in 51-year-old woman with known contralateral breast cancer. Histologic examination after CT-guided excisional biopsy revealed additional 5-mm tubular carcinoma. Lesion (arrow) does not stand out against surrounding tissue on unenhanced coronal MRI (T1-weighted three-dimensional gradient-echo sequence) of left breast.

 


View larger version (183K):

[in a new window]
 
Fig. 1B. Enhancing incidental lesion in 51-year-old woman with known contralateral breast cancer. Histologic examination after CT-guided excisional biopsy revealed additional 5-mm tubular carcinoma. First contrast-enhanced MRI obtained at same position as A reveals small irregularly shaped strongly enhancing incidental lesion (arrow).

 


View larger version (142K):

[in a new window]
 
Fig. 1C. Enhancing incidental lesion in 51-year-old woman with known contralateral breast cancer. Histologic examination after CT-guided excisional biopsy revealed additional 5-mm tubular carcinoma. Axial CT scan obtained after injection of contrast material clearly shows this enhancing incidental lesion (arrow).

 


View larger version (147K):

[in a new window]
 
Fig. 1D. Enhancing incidental lesion in 51-year-old woman with known contralateral breast cancer. Histologic examination after CT-guided excisional biopsy revealed additional 5-mm tubular carcinoma. CT scan obtained after preoperative localization shows guidewire in correct position.

 


View larger version (24K):

[in a new window]
 
Fig. 2. Graph shows outcome of all 274 enhancing incidental lesions, depending on their prospective assessment on MRI (category 2, benign; 3, probably benign; 4a, indefinite; 4b, probably malignant; 5, malignant). Altogether 113 lesions were clarified by histology, 104 followed up on MRI, and 45 followed up on mammography and sonography. Eight were lost to follow-up, and four lesions disappeared on MRI under neoadjuvant chemotherapy.

 


View larger version (126K):

[in a new window]
 
Fig. 3A. Enhancing incidental lesion in 58-year-old woman with history of contralateral breast carcinoma 8 years previously. Histologic examination of this enhancing incidental lesion revealed second primary breast cancer with maximal diameter of 5 mm. Coronal subtraction image from first contrast-enhanced and unenhanced study (T1-weighted dynamic three-dimensional gradient-echo sequence; TR/TE, 15/7; flip angle, 30°) shows slightly irregularly shaped unifocal small enhancing incidental lesion.

 


View larger version (136K):

[in a new window]
 
Fig. 3B. Enhancing incidental lesion in 58-year-old woman with history of contralateral breast carcinoma 8 years previously. Histologic examination of this enhancing incidental lesion revealed second primary breast cancer with maximal diameter of 5 mm. On repeated sonogram, suspicious lesion (between cursors) that had been missed during first examination was found in corresponding location

 


View larger version (138K):

[in a new window]
 
Fig. 3C. Enhancing incidental lesion in 58-year-old woman with history of contralateral breast carcinoma 8 years previously. Histologic examination of this enhancing incidental lesion revealed second primary breast cancer with maximal diameter of 5 mm. This small malignant lesion (A and B) was not seen on either previous mammograms (not shown) or specimen radiograph shown here.

 


View larger version (11K):

[in a new window]
 
Fig. 4. Graph illustrates number of malignant enhancing incidental lesions that could be identified during reevaluation on mammography or sonography (black bars) and that could definitely be seen solely on MRI (white bars), depending on their size.

 


View larger version (21K):

[in a new window]
 
Fig. 5. Flow diagram of proposed management guidelines for enhancing incidental lesions detected on MRI of breast.

 

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2003 by the American Roentgen Ray Society.