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Breast MRI in the Evaluation of Eligibility for Accelerated Partial Breast Irradiation

Juan Godinez1, Eva C. Gombos2, Sona A. Chikarmane2, Gabriel K. Griffin3 and Robyn L. Birdwell2

1 Department of Radiation Oncology, Brigham and Women's Hospital and the Dana-Farber Cancer Institute, 75 Francis St., Boston, MA 02115.
2 Department of Radiology, Brigham and Women's Hospital, Boston, MA.
3 Department of Genetics, Children's Hospital Boston, Boston, MA.


Figure 1
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  		Fig. 1A —48-year-old woman with palpable lesion in right upper breast found by her physician. Mediolateral oblique (A) and craniocaudal (B) mammograms. Patient did not feel lump, and a BB marker was not placed at time of her mammogram. Images were originally interpreted as showing no evidence of suspicious lesion. However, retrospectively, possible asymmetries and architectural distortions may be present centrally (arrows).

 

Figure 2
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  		Fig. 1B —48-year-old woman with palpable lesion in right upper breast found by her physician. Mediolateral oblique (A) and craniocaudal (B) mammograms. Patient did not feel lump, and a BB marker was not placed at time of her mammogram. Images were originally interpreted as showing no evidence of suspicious lesion. However, retrospectively, possible asymmetries and architectural distortions may be present centrally (arrows).

 

Figure 3
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  		Fig. 1C —48-year-old woman with palpable lesion in right upper breast found by her physician. Focal sonogram at site of palpable mass at 12-o'clock position shows highly suspicious irregular hypoechoic 1.4-cm mass (calipers) in posterior breast.

 

Figure 4
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  		Fig. 1D —48-year-old woman with palpable lesion in right upper breast found by her physician. Sagittal contrast-enhanced T1-weighted MR image with fat saturation shows index cancer (long arrow). Second cancer (short arrow) detected on MRI only is seen in inferior breast, 5.5 cm from incident cancer. Subsequent core biopsy confirmed that second area was another focus of grade I invasive ductal carcinoma.

 

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