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MRI Before Reexcision Surgery in Patients with Breast Cancer

Janie M. Lee1,2, Susan G. Orel1, Brian J. Czerniecki3, Lawrence J. Solin4 and Mitchell D. Schnall1

1 Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
2 Department of Radiology, Massachusetts General Hospital, Institute of Technology Assessment, 101 Merrimac St., 10th Fl., Boston, MA 02214.
3 Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.
4 Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104.



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  		Fig. 1. —44-year-old woman with breast cancer and true-negative findings on MRI. Enhanced fat-saturated T1-weighted 3D gradient-echo MRI shows thin rim of enhancement around seroma in biopsy cavity. Pathology revealed no residual cancer.

 


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  		Fig. 2. —41-year-old woman with breast cancer and true-positive findings on MRI. Enhanced fat-saturated T1-weighted 3D gradient-echo MRI shows intense enhancement extending from anteroinferior margin of biopsy cavity suspicious for residual disease. Pathology revealed residual invasive ductal carcinoma.

 


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  		Fig. 3. —63-year-old woman with breast cancer and false-positive findings on MRI. Enhanced fat-saturated T1-weighted 3D gradient-echo MRI shows thick irregular enhancement around biopsy cavity suspicious for residual disease. Pathology revealed proliferative fibrocystic change without residual disease.

 


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  		Fig. 4. —46-year-old woman with breast cancer and false-negative findings on MRI. Enhanced fat-saturated T1-weighted 3D gradient-echo MRI shows thin rim of enhancement (arrows) consistent with recent biopsy. Pathology revealed residual invasive and in situ ductal carcinoma around biopsy cavity.

 


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  		Fig. 5. —71-year-old woman with breast cancer and additional suspicious lesion with malignant histology. Enhanced fat-saturated T1-weighted 3D gradient-echo MRI shows seroma (thin arrows) in upper breast with irregular enhancement suspicious for residual disease. In addition, separate enhancing mass (thick arrow) was seen inferior to seroma that was suspicious for an additional foci of malignancy. Lesion underwent MRI-guided localization and excisional biopsy. Pathology revealed invasive ductal carcinoma.

 


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  		Fig. 6. —71-year-old woman with breast cancer and additional suspicious lesion with benign histology. Enhanced fat-saturated T1-weighted 3D gradient-echo MRI shows seroma (thin arrow) in upper breast with suspicious irregular enhancement. Additional suspicious enhancing lesion (thick arrow) can be seen anterior and inferior to biopsy cavity. Lesion underwent MRI-guided localization and excisional biopsy. Pathology revealed fibrocystic change without malignancy.

 

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