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Comparison of MDCT and MRI for Evaluating the Intraductal Component of Breast Cancer

Akiko Shimauchi1,2, Takayuki Yamada1, Akihiro Sato1, Kei Takase1, Shin Usami3, Takanori Ishida3, Takuya Moriya4 and Shoki Takahashi1

1 Department of Diagnostic Radiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
2 Present address: Section of Breast Imaging, Department of Radiology, 5841 S. Maryland Ave., MC2026, Chicago, IL 60637.
3 Department of Surgical Oncology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
4 Department of Pathology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.


Figure 1
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  		Fig. 1A —Intraductal component of invasive tumors visualized using radiologic imaging. Ductal extension type.

 

Figure 2
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  		Fig. 1B —Intraductal component of invasive tumors visualized using radiologic imaging. Segmental type.

 

Figure 3
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  		Fig. 2A —Evaluation of the length of the intraductal component. IP = initiation point (origin), RM = radiologically determined margin, PM = histopathologically determined margin, SM = surgical margin, RL = radiologically determined length, PL = histopathologically determined length. When the length of the intraductal component is underestimated by less than 15 mm based on radiologic measurements, the surgical margin is negative.

 

Figure 4
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  		Fig. 2B —Evaluation of the length of the intraductal component. IP = initiation point (origin), RM = radiologically determined margin, PM = histopathologically determined margin, SM = surgical margin, RL = radiologically determined length, PL = histopathologically determined length. When the radiology-based underestimation is 15-20 mm, the surgical margin is close.

 

Figure 5
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  		Fig. 2C —Evaluation of the length of the intraductal component. IP = initiation point (origin), RM = radiologically determined margin, PM = histopathologically determined margin, SM = surgical margin, RL = radiologically determined length, PL = histopathologically determined length. When the radiology-based underestimation is ≥ 20 mm, the surgical margin is positive.

 

Figure 6
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  		Fig. 3A —43-year-old woman with invasive ductal carcinoma in right breast. and B, Maximum-intensity-projection (MIP) image of MDCT images reveals location of main tumor (arrows) but not intraductal component.

 

Figure 7
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  		Fig. 3B —43-year-old woman with invasive ductal carcinoma in right breast. Maximum-intensity-projection (MIP) image of MDCT images reveals location of main tumor (arrows) but not intraductal component.

 

Figure 8
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  		Fig. 3C —43-year-old woman with invasive ductal carcinoma in right breast. and D, MIP images of MRI images reveal a clumped enhancement (arrowheads) distal to main tumor (arrows), which was suspected to be intraductal component. Intraductal component distal to main tumor was confirmed on histopathologic examination.

 

Figure 9
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  		Fig. 3D —43-year-old woman with invasive ductal carcinoma in right breast. MIP images of MRI images reveal a clumped enhancement (arrowheads) distal to main tumor (arrows), which was suspected to be intraductal component. Intraductal component distal to main tumor was confirmed on histopathologic examination.

 

Figure 10
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  		Fig. 4A —55-year-old woman with invasive ductal carcinoma in right breast. Oblique partial maximum-intensity-projection (MIP) images of MDCT images. Main tumor is visible (arrows) and spotty enhancements extend toward nipple (arrowheads).

 

Figure 11
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  		Fig. 4B —55-year-old woman with invasive ductal carcinoma in right breast. Oblique partial MIP images of MRI images. Main tumor is visible (arrows), and spotty enhancements extend toward nipple (arrowheads). Note that enhancements are more conspicuous in MRI image.

 

Figure 12
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  		Fig. 4C —55-year-old woman with invasive ductal carcinoma in right breast. Histopathologic map of quadrantectomy specimen. Black zone corresponds to invasive carcinoma. Gray zone corresponds to intraductal component. Note that intraductal component extends toward nipple.

 

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