title: Mammographic, sonographic and MR imaging features of invasive micropapillary breast cancer.
abstract: OBJECTIVE
  Describe mammographic, sonographic and MRI findings of invasive micropapillary carcinoma (IMPC) of the breast.
  
  
  METHODS
  Review of the pathology database identified 43 patients (mean age, 59.3 years) with the diagnosis of breast IMPC. Three patients had no available imaging studies. Mammograms (40), breast ultrasounds (33) and MRIs (8) were retrospectively evaluated by two radiologists in consensus following the BI-RADS Lexicon. Clinical, histopathologic features, as well as hormone status were recorded.
  
  
  RESULTS
  Twenty patients presented with palpable abnormality (20/40, 50%). Thirty-five patients had an abnormal mammogram (87.5%, 35/40) showing 39 lesions, 29 corresponding to masses (29/39, 74.4%), 11 associated with microcalcifications and two associated with architectural distortion. Sonography identified 41 masses (in 33 patients) displaying an irregular shape (30/41, 73.2%), appearing hypoechoic (39/41, 95%), with spiculated or angular margins (26/41, 63.4%), non-parallel orientation (26/41, 63.4%) and combined acoustic posterior pattern (18/41, 44%). MRI identified 13 lesions (in eight patients), 12 as masses (12/13, 92.3%) with irregular or spiculated margins (12/12, 100%), eight displaying an irregular or lobulated shape (8/12, 66.7%), six with homogeneous internal enhancement (6/12, 50%) and eight with type 3 enhancement curve (8/12, 61.5%). Associated non-mass like enhancement was noted in two patients. Twenty-nine patients had associated lymphovascular invasion (29/40, 72.5%) and axillary lymph node metastases were present in 22 of the 39 patients (22/39, 56%).
  
  
  CONCLUSIONS
  Invasive ductal carcinoma with IMPC features display imaging findings highly suspicious of malignant lesions. They are associated with high lymphovascular invasion and lymph node metastases rates.
authors.affiliation: Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, PQ H3H 1A1, Canada.
authors.forename: Shaza
authors.initials: S
authors.lastname: Alsharif
authors.affiliation: Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, PQ H3H 1A1, Canada.
authors.forename: Razan
authors.initials: R
authors.lastname: Daghistani
authors.affiliation: Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, PQ H3H 1A1, Canada.
authors.forename: Elif Aşik
authors.initials: EA
authors.lastname: Kamberoğlu
authors.affiliation: Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, PQ H3H 1A1, Canada.
authors.forename: Atilla
authors.initials: A
authors.lastname: Omeroglu
authors.affiliation: Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, PQ H3H 1A1, Canada.
authors.forename: Sarkis
authors.initials: S
authors.lastname: Meterissian
authors.affiliation: Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, PQ H3H 1A1, Canada. Electronic address: benoit.mesurolle@muhc.mcgill.ca.
authors.forename: Benoît
authors.initials: B
authors.lastname: Mesurolle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D016217:Ultrasonography, Mammary
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Breast MRI; Breast neoplasm; Breast sonography; Invasive micropapillary carcinoma; Mammography