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Simultaneous Bilateral Breast and High-Resolution Axillary MRI of Patients with Breast Cancer: Preliminary Results

¹ Service d'Imagerie Médicale, Hôpital Henri Mondor, 51 Avenue du Maréchal de Lattre de Tassigny, Créteil 94010 Cedex, France.
² Department of Biostatistics, Centre Hospitalo-Universitaire Henri Mondor, Créteil 94010, France.
³ Department of Pathology, Centre Hospitalo-Universitaire Henri Mondor, Créteil 94010, France.
⁴ Department of Plastic Surgery, Centre Hospitalo-Universitaire Henri Mondor, Créteil 94010, France.

View larger version (106K): [in a new window]   Fig. 1. —Photograph of axillary surface coil. This round, light, and flexible axillary surface coil can be easily positioned close to patient's axilla. Coil can be combined with standard bilateral breast coil because of multichannel capability of MRI device.

View larger version (140K): [in a new window]   Fig. 2A. —55-year-old woman with T1 N0 M0 invasive ductal carcinoma of left breast with negative pathologic findings from axillary lymph node dissection. Transverse unenhanced high-resolution T1-weighted image of axilla shows lymph nodes with normal thin C-shaped cortex (arrowhead) and high-signal-intensity hila.

View larger version (101K): [in a new window]   Fig. 2B. —55-year-old woman with T1 N0 M0 invasive ductal carcinoma of left breast with negative pathologic findings from axillary lymph node dissection. Transverse high-resolution inversion recovery T2-weighted image of axilla shows absent central hilar high signal intensity compared with that of muscle.

View larger version (126K): [in a new window]   Fig. 2C. —55-year-old woman with T1 N0 M0 invasive ductal carcinoma of left breast with negative pathologic findings from axillary lymph node dissection. Transverse contrast-enhanced high-resolution T1-weighted image of axilla shows intense visual enhancement is absent.

View larger version (119K): [in a new window]   Fig. 3A. —54-year-old woman with T2 N1 M0 invasive ductal carcinoma and positive pathologic findings from axillary lymph node dissection that revealed extracapsular invasion. Unenhanced T1-weighted image shows large node (arrow) with thick concentric cortex and small central hilum.

View larger version (129K): [in a new window]   Fig. 3B. —54-year-old woman with T2 N1 M0 invasive ductal carcinoma and positive pathologic findings from axillary lymph node dissection that revealed extracapsular invasion. Transverse inversion recovery T2-weighted image shows lymph node (arrow) has irregular, spiculated contours.

View larger version (121K): [in a new window]   Fig. 3C. —54-year-old woman with T2 N1 M0 invasive ductal carcinoma and positive pathologic findings from axillary lymph node dissection that revealed extracapsular invasion. Transverse contrast-enhanced T1-weighted image shows intense visual enhancement of node.

View larger version (113K): [in a new window]   Fig. 4A. —51-year-old woman with T2 N0 M0 invasive ductal carcinoma of right breast. Transverse high-resolution unenhanced T1-weighted image shows two round lymph nodes (arrowhead and arrow) with absent hilum. Axis ratio is 1.

View larger version (112K): [in a new window]   Fig. 4B. —51-year-old woman with T2 N0 M0 invasive ductal carcinoma of right breast. Transverse high-resolution inversion recovery T2-weighted image confirms presence of two round lymph nodes (arrowhead and arrow) with absent hilum and high central signal-intensity. Axis ratio is 1.

View larger version (123K): [in a new window]   Fig. 4C. —51-year-old woman with T2 N0 M0 invasive ductal carcinoma of right breast. Transverse contrast-enhanced high-resolution T1-weighted MR image of axilla shows intense enhancement of both nodes (arrowhead) and irregular shape of posterior contour of largest node.

View larger version (118K): [in a new window]   Fig. 4D. —51-year-old woman with T2 N0 M0 invasive ductal carcinoma of right breast. Photomicrograph of mounted slide shows massively infiltrated lymph node that matches location of largest node, shown in C. Architectural distortion and capsular rupture (arrowhead) that affect only part of node circumference are visible. These findings match MRI findings. (H and E, low power)

View larger version (99K): [in a new window]   Fig. 5. —53-year-old woman with T1 N0 M0 invasive ductal carcinoma of right breast and negative pathologic findings from axillary lymph node dissection. Each node has two MRI features more frequently encountered in metastatic nodes. Transverse high-resolution unenhanced T1-weighted image shows two lymph nodes (asterisk) within axillary fat. In anteriorly located 4-mm large round-shaped (axis ratio = 1) node (arrowhead), no hilum is identified, whereas the more posteriorly located round-shaped (axis ratio = 1) lymph node shows present hilum (arrow) (signal intensity identical to adjacent fat) and subtly eccentric cortex.

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