Skip to main content

Advertisement

SpringerLink
Log in

MRI patterns of invasive lobular cancer: T1 and T2 features

Caratteristiche RM del carcinoma lobulare invasivo della mammella

  • Breast Radiology/Senologia
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to describe magnetic resonance imaging (MRI) patterns in 21 patients with histologically proven invasive lobular cancer (ILC) of the breast.

Materials and methods

We retrospectively reviewed MR images of 21 out of 24 women with ILC of the breast. Three women were excluded from the study because they underwent neoadjuvant chemotherapy after MRI. Thirteen of the 24 women had positive clinical findings. All 24 patients underwent mammography, sonography and MRI. MRI was performed to evaluate disease extent and multifocality/multicentricity before modified radical mastectomy (n=5) or quadrantectomy (n=16). Two experienced radiologists reviewed the MRI scans and described the tumour patterns.

Results

We identified five morphological patterns of ILC: a solitary mass with irregular margins (n=8); a mass with smooth margins (n=5); multiple small enhancing foci with interconnecting enhancing strands (n=4); dominant lesion surrounded by small foci (n=3); one MR examination was negative.

Conclusions

Architectural and dynamic features are important in the interpretation of breast MRI findings. ILC may be detected on MRI as solitary or multiple lesions that correspond to tumour morphology on pathologic examination. False-negative MRI findings do occur in a small percentage of ILC.

Riassunto

Obiettivo

Descrivere le caratteristiche RM di 21 pazienti con carcinoma lobulare della mammella (ILC) istologicamente confermato.

Materiali e metodi

Sono state retrospettivamente valutate le immagini RM di 21 su 24 donne portatrici di ILC della mammella. Tre donne sono state escluse dallo studio, in quanto sottoposte a chemioterapia neo-adiuvante dopo l’indagine RM. Tredici donne su 24 presentavano una obiettività clinica. Tutte le 24 pazienti sono state sottoposte a mammografia, ecografia della mammella ed RM. RM è stata effettuata per valutare l’estensione locale di malattia e l’eventuale presenza di multifocalità o multicentricità, prima che le pazienti fossero sotttoposte a mastectomia radicale modificata (n=5) o quadrantectomia (n=16). Due radiologi esperti in diagnostica senologica hanno rivisto le immagini RM e descritto i patterns morfologici delle lesioni tumorali riscontrate.

Risultati

Sono stati riscontrati 5 patterns morfologici di ILC: una formazione espansiva singola a bordi irregolari (n=8); una formazione espansiva singola a bordi netti (n=5); piccoli foci multipli di impregnazione contrastografica interconnessi tra loro (n=4); una formazione espansiva principale circondata da piccoli foci satelliti (n=3); una indagine RM negativa.

Conclusioni

Le caratteristiche morfologiche e dinamiche sono importanti nell’interpretazione della RM mammaria. ILC può essere identificato dalla RM sulla base della presenza di lesioni solitarie o multiple, che corrispondono ai reperti anatomo-patologici. Indagini RM negative sono rare, ma possibili in una bassa percentuale di ILC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References/Bibliografia

  1. Weinstein SP, Orel SG, Heller R et al (2001) MR imaging of the breast in patients with invasive lobular carcinoma. AJR Am J Roentgenol 176:399–406

    PubMed  CAS  Google Scholar 

  2. Sastre-Garau X, Jouve B, Asselain B et al (1996) Infiltrating lobular carcinoma of the breast: clinico-pathologic analysis of 975 cases with reference to data on conservative therapy and metastatic patterns. Cancer 77:113–120

    Article  PubMed  CAS  Google Scholar 

  3. Foote FW Jr, Stewart FW (1941) Lobular carcinoma in situ: a rare form of mammary cancer. Am J Pathol 17:491–496

    PubMed  Google Scholar 

  4. Rodenko GN, Harms SE, Pruneda JM et al (1996) MR Imaging in the management before surgery of lobular carcinoma of the breast: correlation with pathology. AJR Am J Roentgenol 167:1415–1419

    PubMed  CAS  Google Scholar 

  5. Framarino Dei Malatesta M, Fiorelli C et al (1995) Infiltrating Lobular Carcinoma of the breast (ILC). Eur J Gynaec Oncol 1:36–39

    Google Scholar 

  6. Rosen PP (1991) The pathology of invasive breast carcinoma. In: Harris JR, Henderson IC, Kinne DW (eds) Breast diseases 2nd ed. Lippincot, Philadelphia, pp 272–276

    Google Scholar 

  7. Kreke KN, Gisvold JJ (1993) Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. AJR Am J Roentgenol 161:957–960

    Google Scholar 

  8. Hilleren DJ, Andersson IT, Lindholm K, Linell FS (1991) Invasive lobular carcinoma: mammographic findings in a 10-year experience. Radiology 178:149–154

    PubMed  CAS  Google Scholar 

  9. Le Gal M, Ollivier L, Asselain B et al (1992) Mammographic features of 455 invasive carcinomas. Radiology 185:705–708

    PubMed  CAS  Google Scholar 

  10. Butler RS, Venta LA, Wiley EL et al (1999) Sonographic evaluation of infiltrating lobular carcinoma. AJR Am J Roentgenol 172:325–330

    PubMed  CAS  Google Scholar 

  11. Sickles EA (1991) The subtle and atypical mammographic features of invasive lobular carcinoma. Radiology 178:25–26

    PubMed  CAS  Google Scholar 

  12. Watson L (2001) Breast cancer: diagnosis, treatment and prognosis. Radiol Technol 73:45–61

    PubMed  CAS  Google Scholar 

  13. Paramugal CP, Helvie MA, Adler DD (1995) Invasive lobular carcinoma: sonographic appearance and role of sonography in improving diagnostic sensitivity. Radiology 195:231–234

    Google Scholar 

  14. Lesser ML, Rosen PP, Kinne DW (1982) Multicentricity and bilaterality in invasive carcinoma. Surgery 91:234–240

    PubMed  CAS  Google Scholar 

  15. Dixon JM, Anderson TJ, Page DL et al (1983) Infiltrating lobular carcinoma of the breast: an evaluation of the incidence and consequence of bilateral disease. Br J Surg 70:513–516

    Article  PubMed  CAS  Google Scholar 

  16. Boetes C, Mus RDM, Holland R et al (1995) Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology 197:743–747

    PubMed  CAS  Google Scholar 

  17. Qayyum A, Birdwell RL, Daniel BL et al (2002) MR imaging features of infiltrating lobular carcinoma of the breast: histopathologic correlation. AJR Am J Roentgenol 178:1227–1232

    PubMed  Google Scholar 

  18. Kaiser WA, Zeitler E (1989) MR imaging of breast: fast imaging sequences with and without Gd-DTPA. Preliminary observations. Radiology 170:681–686

    PubMed  CAS  Google Scholar 

  19. Harms SE, Flamig DP, Hesley KL et al (1993) MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. Radiology 187:493–501

    PubMed  CAS  Google Scholar 

  20. Boetes C, Barentsz JO, Mus RD et al (1994) MR characterization of suspicious breast lesions with a gadolinium-enhanced TurboFLASH subtraction technique. Radiology 193:777–781

    PubMed  CAS  Google Scholar 

  21. Heywang-Kobrunner SH, Viehweg P, Heinig A, Kuchler C (1997) Contrastenhanced MRI of the breast: accuracy, value, controversies, solutions. Eur J Radiol 24:94–108

    Article  PubMed  CAS  Google Scholar 

  22. Sherif H, Mahfouz AE, Oellinger H et al (1997) Peripheral washout sign on contrast enhancement MR images of the breast. Radiology 205:209–213

    PubMed  CAS  Google Scholar 

  23. Kuhl CK, Mielcarek P, Klaschik S et al (1999) Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions? Radiology 211:101–110

    PubMed  CAS  Google Scholar 

  24. Kim SJ, Morris EA, Liberman L et al (2001) Observer variability and application of BI-RADS terminology for breast MR Imaging. AJR Am J Roentgenol 177:551–557

    PubMed  CAS  Google Scholar 

  25. American College of Radiology (ACR) (1998) Illustrated breast imaging reporting and data system (BI-RADS), 3rd edn. American College of Radiology, Reston, VA

    Google Scholar 

  26. Lehman CD, Peacock S, DeMartini WB, Chen X (2006) A new automated software system to evaluate breast MR examinations: improved specificity without decreased sensitivity. AJR Am J Roentgenol 187:51–56

    Article  PubMed  Google Scholar 

  27. Gisvold JJ (1990) Imaging of the breast: techniques and results. Mayo Clin Proc 65:56–66

    PubMed  CAS  Google Scholar 

  28. Mendelson EB, Harris KM, Doshu N, Tobon H (1989) Infiltrating lobular carcinoma: mammographic patterns with pathologic correlation. AJR Am J Roentgenol 153:265–271

    PubMed  CAS  Google Scholar 

  29. Yeh C, Titus JM, Kalisher L (1997) Breast imaging case of the day. Infiltrating lobular carcinoma. Radiographics 17:1328–1332

    PubMed  CAS  Google Scholar 

  30. Cornford EJ, Wilson ARM, Athanassiou E et al (1995) Mammographic features of invasive lobular and invasive ductal carcinoma of the breast: a comparative analysis. Br J Radiol 68:450–453

    Article  PubMed  CAS  Google Scholar 

  31. Holland R, Hendriks JH, Mravunac M (1983) Mammographically occult breast cancer. Cancer 52:1810–1819

    Article  PubMed  CAS  Google Scholar 

  32. Dornkers DS (1985) Mammographisch occult mammacarcinoom. Ned Tijdschr Geneesk 129:1632–1635

    Google Scholar 

  33. Martin JE, Moskowitz M, Milbrath JR (1979) Breast cancer missed by mammography. AJR Am J Roentgenol 132:737–739

    PubMed  CAS  Google Scholar 

  34. Beute BJ, Kalisher L, Hutter RV (1991). Lobular carcinoma in situ of the breast: clinical, pathologic, and mammographic features. AJR Am J Roentgenol 157:257–265

    PubMed  CAS  Google Scholar 

  35. Skaane P, Skjorten F (1999) Ultrasonographic evaluation of invasive lobular carcinoma. ACTA Radiol 40:369–375

    Article  PubMed  CAS  Google Scholar 

  36. Evans N, Lyons K (2000) The use of ultrasound in the diagnosis of invasive lobular carcinoma of the breast less than 10 mm in size. Clin Radiol 55:261–263

    Article  PubMed  CAS  Google Scholar 

  37. Chintana PP, Helvie MA, Adler DD (1995) Invasive lobular carcinoma: sonographic appearance and role of sonography in improving diagnostic sensitivity. Radiology 195:231–234

    Google Scholar 

  38. Nokes SR, Pierce W, Abraham DC, Harms SE (1999) Radiology, infiltrating lobular carcinoma. J Ark Med Soc 96:176–177

    PubMed  CAS  Google Scholar 

  39. Harms SE (1998) Integration of breast magnetic resonance imaging with breast cancer treatment. Top Magn Reson Imaging 9:79–91

    Article  PubMed  CAS  Google Scholar 

  40. Schelfout K, Van Goethem M, Kersschot E et al (2004) Preoperative breast MRI in patients with invasive lobular breast cancer. Eur Radiol 14:1209–1216

    Article  PubMed  CAS  Google Scholar 

  41. Levrini G, Nicol F, Borasi G et al (2006) MRI patterns of invasive lobular breast cancer. Eur J Radiol 59:472

    Article  PubMed  Google Scholar 

  42. Mumtaz H, Hall-Craggs MA, Davidson T et al (1997) Staging of symptomatic primary breast cancer with MR imaging. AJR Am J Roentgenol 169:417–424

    PubMed  CAS  Google Scholar 

  43. Orel SG, Schnall MD, Powell CM et al (1995) Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. Radiology 196:115–122

    PubMed  CAS  Google Scholar 

  44. Cooney BS, Orel SG, Schnall MD, Troupin RH (1994) Invasive lobular carcinoma in a patient with synchronous ductal carcinoma in situ: detection with MR imaging. AJR Am J Roentgenol 162:1318–1320

    PubMed  CAS  Google Scholar 

  45. Esserman L, Hylton N, Yassa L et al (1999) Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol 17:110–119

    PubMed  CAS  Google Scholar 

  46. Fischer U, Kopka L, Grabbe E (1999) Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology 213:881–888

    PubMed  CAS  Google Scholar 

  47. Davis PL, McCarty KS Jr (1998) Magnetic resonance imaging in breast cancer staging. Top Magn Reson Imaging 9:60–75

    Article  PubMed  CAS  Google Scholar 

  48. Orel SG, Weinstein SP, Schnall MD (1999) Breast MR imaging in patients with axillary node metastases and unknown primary malignancy. Radiology 212:543–549

    PubMed  CAS  Google Scholar 

  49. Wilhem K, Grebe P, Teifke A et al (1992) Das Lobulare Mammakarzinom in der Kerspintomographie. Akt Radiol 2:373

    Google Scholar 

  50. Perry N, Broeders M, de Wolf C, Tornberg S, Schouten J (eds) (1996) European Guidelines for Quality Assurance in Mammography Screening. 2nd edn. European Commission, Brussels

    Google Scholar 

  51. Orel SG, Schnall MD, LiVolsi VA, Troupin RH (1994) Suspicious breast lesions: MR imaging with radiologicpathologic correlation. Radiology 190:485–493

    PubMed  CAS  Google Scholar 

  52. Stelling CB, Powell DE, Mattingly SS (1987) Fibroadenomas: histopathologic and MR imaging features. Radiology 162:399–407

    PubMed  CAS  Google Scholar 

  53. Heywang SH, Bassermann R, Fenzl G et al (1987) MRI of the breast: histopathologic correlation. Eur J Radiol 7:175–182

    PubMed  CAS  Google Scholar 

  54. Kuhl CK, Klaschik S, Mielcarek P et al (1999) Do T2-weighted pulse sequences help with the differential diagnosis of enhancing lesions in dynamic breast MRI? J Magn Reson Imaging 9:187–196

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Diagnostica per Immagini, Azienda Ospedaliera Santa Maria Nuova, Viale Risorgimento 80, 42100, Reggio Emilia, Italy

    G. Levrini, C. A. Mori, R. Vacondio, G. Borasi & F. Nicoli

Authors
  1. G. Levrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. A. Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Vacondio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Borasi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Nicoli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Levrini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Levrini, G., Mori, C.A., Vacondio, R. et al. MRI patterns of invasive lobular cancer: T1 and T2 features. Radiol med 113, 1110–1125 (2008). https://doi.org/10.1007/s11547-008-0308-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-008-0308-z

Keywords

Parole chiave

Search

Navigation