Magnetic resonance imaging detects unsuspected disease in patients with invasive lobular cancer.
BACKGROUND
Predicting the extent of disease in the breasts of patients with invasive lobular cancer (ILC) can be difficult because of the limits of physical examination and standard imaging. We determined the utility of magnetic resonance imaging (MRI) in finding otherwise unsuspected cancer in the ipsilateral or contralateral breast of patients with ILC.


METHODS
Through database review of all breast MRIs performed between January 1, 1999, and December 30, 2002, we identified patients with newly diagnosed ILC who underwent an MRI for extent-of-disease evaluation or contralateral screening. MRI findings separate from the primary tumor were biopsied and correlated with pathology by using MRI-guided biopsy.


RESULTS
Sixty-two patients were identified. In all, 59 ipsilateral and 57 contralateral studies were performed. Suspicious lesions separate from the primary tumor were found by MRI in 38 (61%) of 62 patients. Eight patients were excluded from further analysis (seven elected mastectomy without biopsy; one had an unguided excision). Nineteen of 51 patients with an ipsilateral finding underwent MRI-guided biopsy, which revealed cancer in 11, or 22% of those imaged. Twenty of 53 patients with a contralateral finding underwent MRI-guided biopsy, which revealed cancer in 5, or 9% of those imaged.


CONCLUSIONS
MRI of the breast identifies unsuspected multicentric or contralateral cancer in patients with ILC. These findings support the use of MRI in selected patients with ILC, particularly in the ipsilateral breast.
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
M L
ML
Quan
L
L
Sclafani
A S
AS
Heerdt
J V
JV
Fey
E A
EA
Morris
P I
PI
Borgen
D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000473:pathology*; D018579:Patient Selection; D012189:Retrospective Studies; D012680:Sensitivity and Specificity