title: Can T2-weighted 3-T breast MRI predict clinically occult inflammatory breast cancer before pathological examination? A single-center experience.
abstract: Occult inflammatory breast cancer (IBC) is defined as an invasive cancer without any clinical inflammatory signs but with pathologically proven dermal lymphovascular invasion. The purpose of this study is to evaluate the ability of 3-T breast MRI to predict occult IBC before pathological examination and compare its effectiveness with that of mammography (MMG) and ultrasound (US). A retrospective review of clinical, radiological, and pathological records of 460 consecutive breast cancers revealed five proved occult IBCs. We analyzed the findings of 3-T MRI, MMG, and US for these five occult IBCs. Primary breast lesions were detected by 3-T MRI, MMG, and US in all five breasts with occult IBCs. 3-T MRI revealed 40% mass type lesions and 60% non-mass-like type lesions. Kinetic curve analysis of the primary breast lesions showed a rapid initial kinetic phase in 80% of lesions and a delayed washout pattern in 60% of lesions. 3-T MRI showed slight skin thickness in 60% of breasts, whereas MMG and US showed slight skin thickness in 40 and 20% of breasts, respectively. Subcutaneous and prepectoral edema, as evaluated on T2-weighted images, was present in all five breasts with occult IBCs. The presence of subcutaneous and prepectoral edema on T2-weighted 3-T breast MRI is an important finding that should suggest the diagnosis of occult IBC before pathological examination.
authors.affiliation: Breast Imaging and Breast Intervention Section, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan, t.uematsu@scchr.jp.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Uematsu
authors.forename: Masako
authors.initials: M
authors.lastname: Kasami
authors.forename: Junichiro
authors.initials: J
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001941:Breast Diseases / Q000175:diagnosis; D004487:Edema / Q000175:diagnosis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D058922:Inflammatory Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D012189:Retrospective Studies; D016217:Ultrasonography, Mammary