title: Role of breast magnetic resonance imaging in determining breast as a source of unknown metastatic lymphadenopathy.
abstract: BACKGROUND
  Occult primary breast cancer (OPBC) represents less than 1% of breast cancer. In only a third of cases, mammography identifies a primary tumor. We hypothesized that rotating delivery of excitation off-resonance breast magnetic resonance imaging (MRI) would identify or exclude the breast as a primary site in patients with OPBC.
  
  
  METHODS
  In a retrospective review, 10 patients were identified with OPBC in which MRI was performed. Malignant appearing lesions were correlated with histopathologic findings at biopsy or surgery.
  
  
  RESULTS
  MRI identified the primary site in 8 of 10 cases as breast (80%), and excluded it in 2 cases. The extent of disease and location was accurately predicted when compared with histopathologic specimen.
  
  
  CONCLUSIONS
  As we continue to focus on a cure of early breast cancer, it is imperative that diagnostic images become more sensitive and specific. MRI accurately predicted OPBC in this subset of patients.
authors.affiliation: Department of Surgery, University of Arkansas for Medical Sciences, John L. McClellan Veterans Administration Hospital, Little Rock 72205, USA.
authors.forename: R S
authors.initials: RS
authors.lastname: Henry-Tillman
authors.forename: S E
authors.initials: SE
authors.lastname: Harms
authors.forename: K C
authors.initials: KC
authors.lastname: Westbrook
authors.forename: S
authors.initials: S
authors.lastname: Korourian
authors.forename: V S
authors.initials: VS
authors.lastname: Klimberg
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity