Nonpalpable mammographically occult invasive breast cancers detected by MRI.
OBJECTIVE
The purpose of this study was to determine the MRI findings and histology of clinically and mammographically occult invasive breast cancers detected by MRI.


METHODS
A retrospective review was undertaken of 1,336 breast MRI examinations performed during a 2-year period. Among these, 68 nonpalpable mammographically occult invasive cancers were identified in 57 women with a median age of 50 years (range, 30-72 years). MRI findings were classified according to the breast MRI lexicon. Medical records were reviewed to determine the histology.


RESULTS
Indications for performing MRI were extent of disease assessment in 72% (41/57), high-risk screening in 25% (14/57), and problem solving in 3% (2/57). MRI lesion types in these 68 invasive cancers were nonmass in 57% (39/68) and mass in 43% (29/68). Kinetics were plateau in 59% (40/68), washout in 38% (26/68), and persistent in 3% (2/68). Histology was invasive ductal cancer in 65% (44/68), mixed invasive ductal and lobular cancer in 19% (13/68), and invasive lobular cancer in 16% (11/68). The cancer stage was I in 61% (34/56), II in 32% (18/56), and more advanced in 7% (4/56). Sixty-three percent (43/68) of lesions were minimal cancers, defined as invasive cancers measuring under 1 cm.


CONCLUSIONS
In this study of mammographically and clinically occult cancers detected by MRI, 57% (39/68) of invasive breast cancers were evident as nonmass enhancement, and 63% were minimal breast cancers.
Bartella
Lia
L
Department of Radiology, Breast Imaging Section, Memorial Sloan-Kettering Cancer Center, H118, 1275 York Ave., New York, NY 10021, USA. bartelll@mskcc.org
Liberman
Laura
L
Morris
Elizabeth A
EA
Dershaw
D David
DD
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D012189:Retrospective Studies