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Contrast-Enhanced Breast MRI in Patients with Suspicious Microcalcifications on Mammography: Results of a Multicenter Trial

Massimo Bazzocchi1, Chiara Zuiani1, Pietro Panizza2, Chiara Del Frate1, Franca Soldano3, Miriam Isola3, Francesco Sardanelli4, Gian Marco Giuseppetti5, Giovanni Simonetti6, Vincenzo Lattanzio7 and Alessandro Del Maschio2

1 Institute of Radiology, University of Udine, Via Colugna 50, Udine 33100, Italy.
2 Department of Radiology, Vita-Salute University, San Raffaele Hospital, Milan, Italy.
3 Department of Medical Statistics, Faculty of Medicine, University of Udine, Udine, Italy.
4 Department of Diagnostic Imaging, Istituto Policlinico San Donato, Milan, Italy.
5 Institute of Radiology, University of Ancona, Ancona, Italy.
6 Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, Italy.
7 Department of Senology, Policlinico Universitario Bari, Bari, Italy.


Figure 1
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  		Fig. 1A —Proliferative fibrocystic disease in left breast of 75-year-old woman. Mediolateral view (A), magnification mammogram (B), and mammographic magnification view of surgical specimen (C) show pleomorphic calcifications in upper outer quadrant (arrows, A and B).

 

Figure 2
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  		Fig. 1B —Proliferative fibrocystic disease in left breast of 75-year-old woman. Mediolateral view (A), magnification mammogram (B), and mammographic magnification view of surgical specimen (C) show pleomorphic calcifications in upper outer quadrant (arrows, A and B).

 

Figure 3
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  		Fig. 1C —Proliferative fibrocystic disease in left breast of 75-year-old woman. Mediolateral view (A), magnification mammogram (B), and mammographic magnification view of surgical specimen (C) show pleomorphic calcifications in upper outer quadrant (arrows, A and B).

 

Figure 4
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  		Fig. 1D —Proliferative fibrocystic disease in left breast of 75-year-old woman. Subtracted MR image (coronal plane) shows focal contrast enhancement (arrow).

 

Figure 5
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  		Fig. 1E —Proliferative fibrocystic disease in left breast of 75-year-old woman. Signal intensity-time curve shows type 2 time curve, with rapid enhancement in first minute and plateau in next four minutes.

 

Figure 6
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  		Fig. 2A —Ductal carcinoma in situ in left breast of 44-year-old woman. Oblique view mammogram and mammographic magnification view of surgical specimen shows cluster of punctate calcifications (arrow) close to hookwire.

 

Figure 7
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  		Fig. 2B —Ductal carcinoma in situ in left breast of 44-year-old woman. Oblique view mammogram and mammographic magnification view of surgical specimen shows cluster of punctate calcifications (arrow) close to hookwire.

 

Figure 8
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  		Fig. 2C —Ductal carcinoma in situ in left breast of 44-year-old woman. The MR study (axial plane) does not show any foci of enhancement.

 

Figure 9
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  		Fig. 3A —Ductal carcinoma in situ in right breast of 50-year-old woman. Craniocaudal mammogram shows segmental area of punctate irregular microcalcifications (arrow).

 

Figure 10
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  		Fig. 3B —Ductal carcinoma in situ in right breast of 50-year-old woman. Contrast-enhanced coronal and axial plane subtracted images reveal two enhancing foci (arrows).

 

Figure 11
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  		Fig. 3B —Ductal carcinoma in situ in right breast of 50-year-old woman. Contrast-enhanced coronal and axial plane subtracted images reveal two enhancing foci (arrows).

 

Figure 12
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  		Fig. 4A —Invasive ductal carcinoma in right breast of 67-year-old woman. Mammographic magnification view shows linear branching arrangement of microcalcifications (arrow).

 

Figure 13
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  		Fig. 4B —Invasive ductal carcinoma in right breast of 67-year-old woman. Contrast-enhanced subtracted MR images in coronal (B) and axial (C) planes show focal contrast enhancement of lesion with ill-defined margin (arrow).

 

Figure 14
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  		Fig. 4C —Invasive ductal carcinoma in right breast of 67-year-old woman. Contrast-enhanced subtracted MR images in coronal (B) and axial (C) planes show focal contrast enhancement of lesion with ill-defined margin (arrow).

 

Figure 15
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  		Fig. 4D —Invasive ductal carcinoma in right breast of 67-year-old woman. Signal intensity-time curve shows typical curve for malignant lesions with rapid enhancement in first minute and rapid washout in next four minutes.

 

Figure 16
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  		Fig. 5 —Scatterplot shows maximal lesion diameters measured on mammography and pathologic examinations.

 

Figure 17
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  		Fig. 6 —Scatterplot shows maximal lesion diameters measured on MR and pathologic examinations.

 

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