Magnetic resonance imaging of breast vascularity in medial versus lateral breast cancer.
OBJECTIVE
Breasts with malignant tumors can demonstrate a general increased vascularity compared to the contralateral breast and a prominent blood vessel adjacent to the tumor on magnetic resonance imaging (MRI). The aim of the study was to further characterize these alterations in blood supply by location of the tumor within the breast using MRI.


METHODS
The study group included 105 patients who underwent breast MRI for suspicion of a malignancy over a 2-year period. Fifty-one had pathologically verified malignant tumors (study group), 11 had pathologically verified benign lesions (control), and 43 had negative scans (control). The malignant lesions were distinguished by location, medial or lateral, within the breast. Origin of the vascular supply and vessel diameter was recorded in a blinded manner. When available, MRI scans performed 2 years after treatment were reviewed as well.


RESULTS
Of the 24 medial malignant tumors, 21 (87%) had a predominantly medial vascular supply and 3 (13%), a predominantly lateral supply; of the 23 lateral tumors, 11 (48%) had a predominantly medial vascular supply and 8 (35%), a predominantly lateral supply (p=0.03). In 4 cases, no dominant vessel was noted. Maximum vessel diameter was 3.6+/-1.1mm in the patients with malignancy and 2.6 +/- 0.8mm in the controls (p<0.0005). General increased vascularity was demonstrated in 91% of the medial tumor subgroup and 83% of the lateral tumor subgroup, as opposed to 36-37% in the control groups (p<0.0005). Follow-up MRI, performed in 8 patients in the malignant-tumor group after treatment, revealed a considerable decrease in the prominent vessels, to a size close to that of the controls.


CONCLUSIONS
Breasts with malignant tumors are characterized by an altered general vascular supply, a prominent feeding vessel, and increased regional vascularity. Both the presence and location of the tumor affect the vascular supply. The vascular change apparently diminishes after treatment, although this finding requires further investigation in a larger sample.
Grubstein
A
A
Sackler Faculty of Medicine, Radiology Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Tel Aviv University, Tel Aviv, Israel. Ahuva.efi@gmail.com
Yepes
M
M
Kiszonas
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000098:blood supply*; D001943:Breast Neoplasms / Q000098:blood supply* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013895:Thoracic Arteries / Q000473:pathology
D003287:Contrast Media; D019786:Gadolinium DTPA