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Characterization of Lesions of the Breast with Proton MR Spectroscopy: Comparison of Carcinomas, Benign Lesions, and Phyllodes Tumors

Gary M. K. Tse1, Humairah S. Cheung2,3, Lai-Man Pang2, Winnie C. W. Chu2, Bonita K. B. Law4, Fred Y. L. Kung1 and David K. W. Yeung5

1 Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Chinese University of Hong Kong, Ngan Shing St., Shatin, Hong Kong, SAR China.
2 Department of Radiology and Organ Imaging, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
3 Present address: Department of Radiology, Kulliyyah of Medicine, International Islamic University Malaysia, PO Box 141, 25710 Kuantan, Pahang DM, Malaysia.
4 Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.
5 Department of Clinical Oncology, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.



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  		Fig. 1A. —36-year-old woman with borderline malignant phyllodes tumor. Subtracted T1-weighted axial image (TR/TE, 450/12) shows phyllodes tumor (arrow) with smooth well-circumscribed border.

 


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  		Fig. 2A. —41-year-old woman with infiltrating ductal carcinoma. Subtracted T1-weighted axial image (TR/TE, 450/12) shows irregularly shaped infiltrating ductal carcinoma (arrow) with microlobulated border.

 


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  		Fig. 3. —Graph shows spectra of three representative lesions acquired with 135-msec TE. Infiltrating ductal carcinoma (IDC) shows choline peak (Cho) at 3.2 ppm, but similar signal is not seen in either fibroadenoma (FA) or phyllodes tumor (PT).

 


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  		Fig. 2B. —41-year-old woman with infiltrating ductal carcinoma. Photomicrographs of histopathologic specimens show infiltrating ductal carcinoma (H and E, x100) (B) and positive immunostaining for HER2/neu oncogene (diaminobenzidine, x100) (C).

 


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  		Fig. 2C. —41-year-old woman with infiltrating ductal carcinoma. Photomicrographs of histopathologic specimens show infiltrating ductal carcinoma (H and E, x100) (B) and positive immunostaining for HER2/neu oncogene (diaminobenzidine, x100) (C).

 


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  		Fig. 1B. —36-year-old woman with borderline malignant phyllodes tumor. Photomicrographs of histopathologic specimens show phyllodes tumor of borderline malignancy with H and E (diaminobenzidine, x100) (B) and negative immunostaining for HER2/neu oncogene (x100) (C).

 


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  		Fig. 1C. —36-year-old woman with borderline malignant phyllodes tumor. Photomicrographs of histopathologic specimens show phyllodes tumor of borderline malignancy with H and E (diaminobenzidine, x100) (B) and negative immunostaining for HER2/neu oncogene (x100) (C).

 

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