[Dynamic MR-mammography in invasive lobular breast cancer].
OBJECTIVE
The objective of our study was to test the reliability of dynamic, contrast-enhanced MR-mammography (MR-M) in the detection of invasive lobular carcinoma (ILC) and to test if additional examination with MR-M increases the sensitivity of conventional mammography (Mx) in the detection of ILC.


METHODS
We carried out 1,505 MR-Mammographies in 1,357 patients. Biopsy was indicated in 413 cases. Among the malignancies, 23/214 (10.7%) were ILC. MR-M was performed with a 1.0 T whole body MRI system with a dynamic FLASH-3D sequence. Relative signal enhancement within lesions detected and morphologic pattern of contrast enhancement (mep) were determined. Three types of mep were distinguished: type 1 without contrast enhancement, type 2 with focal contrast enhancement and type 3 with diffuse contrast enhancement of the glandular body.


RESULTS
Within MR-M alone, 19/23 (82.6%) of ILC were detected due to a mep type 2. Four ILC were false negative on MR-M (2 cases show mep type 1 or mep type 3). The sensitivity of Mx alone was 86.9% (20/23). When both Mx and MR-M were combined, all 23 ILC were detected. The addition of MR-M to Mx may increase sensitivity to about 100% in the detection of ILC.


CONCLUSIONS
Unsuspicuous MR-M (mep type 1) or diffuse uptake of contrast media (mep type 3) does not rule out malignancy in the presence of suspicious findings at Mx.
Sittek
H
H
Institut für Radiologische Diagnostik, Ludwig-Maximilians-Universität, München.
Perlet
C
C
Untch
M
M
Kessler
M
M
Reiser
M
M
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000175:diagnosis / Q000473:pathology