MR Imaging of Mucinous Carcinoma of the Breast Associated with Ductal Carcinoma In Situ: Case Report

A mucinous carcinoma of the breast is an uncommon carcinoma containing mucin that is associated with a mucocele-like tumor or other malignant tumors. We report the MR imagingfindings of two cases, a mucinous carcinoma and ductal carcinoma in situ (DCIS), associated with mucocele-like tumor. The mucinous carcinoma showed a gradually enhancing kinetic pattern on the dynamic MR and high signal intensity on the T2-weighted images. The MR findings were indistinguishable from a common benign mass of the breast.

MR Imaging of Mucinous Carcinoma of the Breast Associated with Ductal Carcinoma In Situ: Case Report

A mucinous carcinoma of the breast is an uncommon carcinoma containing mucin that is associated with a mucocele-like tumor or other malignant tumors. We report the MR imagingfindings of two cases, a mucinous carcinoma and ductal carcinoma in situ (DCIS), associated with mucocele-like tumor. The mucinous carcinoma showed a gradually enhancing kinetic pattern on the dynamic MR and high signal intensity on the T2-weighted images. The MR findings were indistinguishable from a common benign mass of the breast.

Usefulness of preoperative breast MRI in breast cancer: Comparison with breast US

PURPOSE: The purpose of this study was to evaluate the usefulness of preoperative breast MRI compared with breast US and pathologic finding in breast cancer patients MATERIALS AND METHODS: A total of 50 patients with breast cancer underwent surgery at our institute between October 2004 and August 2005. They were examined preoperatively with MRI and US. The maximum diameter and the number of the lesions on MRI and US were measured. These measurements were subsequently compared with the pathologic results. The results were divided into the equal, overestimated and underestimated groups. Changes of the therapeutic approach, based on MRI, were also evaluated. RESULTS: Breast cancer was correctly evaluated in 38 of 50 (76%) patients with MRI and in 28 of 50 (56%) patients with US; the cancer was overestimated in 7 of 50 (14%) patients with MRI and in 8 of 50 (16%) patients with US; the cancer was underestimated in 5 of 50 (10%) patients with MRI and in 14 of 50 (28%) patients with US. The therapeutic approach was changed in 11 of 50 (22%) patients, and all the cases underwent modified radical mastectomy. The therapeutic approach was correctly changed in 9 (18%) patients. Unnecessary wider excision was performed in 2 (4%) patients. CONCLUSION: In conclusion, preoperative breast MRI may be a useful modality for preoperative evaluation, especially for the local staging of tumor and the treatment planning of patients with breast cancer.

Human in-vivo 31P MR Spectroscopy of Benign and Malignant Breast Tumors

OBJECTIVE: To assess the potential clinical utility of in-vivo 31P magnetic resonance spectroscopy (MRS) in patients with various malignant and benign breast lesions. MATERIALS AND METHODS: Seventeen patients with untreated primary malignant breast lesions (group I), eight patients with untreated benign breast lesions (group II) and seven normal breasts (group III) were included in this study. In-vivo 31P MRS was performed using a 1.5 Tesla MR scanner. Because of the characteristics of the coil, the volume of the tumor had to exceed 12 cc (3 x 2 x 2 cm), with a superoinferior diameter at least 3 cm. Mean and standard deviations of each metabolite were calculated and metabolite ratios, such as PME/PCr, PDE/PCr, T-ATP/PCr and PCr/T-ATP were calculated and statistically analyzed. RESULTS: Significant differences in PME were noted between groups I and III (p=0.0213), and between groups II and III (p=0.0213). The metabolite ratios which showed significant differences were PME/PCr (between groups II and III) (p=0.0201), PDE/PCr (between groups I and III, and between groups II and III) (p=0.0172), T-ATP/PCr (between groups II and III) (p=0.0287), and PCr/T-ATP (between groups II and III) (p=0.0287). There were no significant parameters between groups I and II. CONCLUSION: In-vivo 31P MRS is not helpful for establishing a differential diagnosis between benign and malignant breast lesions, at least with relatively large lesions greater than 3 cm in one or more dimensions.

Human Breast Cancer: In Vivo And In Vitro H MR Spectroscopy

PURPOSE: The purpose of this study was to determine, using in vivo and in vitro 1H MRS (MR spectroscopy), the characteristic biochemical metabolites related with breast cancer, and to assess the clinical usefulness and limitations of this modality. MATERIALS AND METHODS: For in vivo 1H MRS, nine patients with breast cancer and two normal volunteers were examined on a 1.5 T MR imager equipped with facilities for spectroscopy. In order to localize the breast lesion, axial and sagittal T1-weighted images and fat-suppressed T2-weighted images were obtained just prior to MRS; MR spectra were acquired at TR=3000 msec and TE=144 msec. For in vitro 1H MRS, breast tumor and adja-cent normal tissue were extracted from 13 patients with breast cancer, and in two of these, both in vivo and in vitro 1H MRS were performed. All in vitro 1H MRS specimens were immediately immersed in liquid nitrogen, and then in a preparation of perchloric acid. For quantitative analysis of the MR spectra of cancerous and normal breast tissue, the paired t-test was used (p < 0.05). RESULTS: At1H MRS in vivo, choline and two lipids were identified at 3.21 ppm, and 1.33 ppm and 0.9 ppm, re-spectively. The distinction between cancerous and normal breast tissue was based on the higher level of choline (3.21 ppm) present in the former. At 1H MRS in vitro, on the other hand, mean and standard deviation (% standard deviation) for the various metabolites in cancerous and normal breast tissue were as follows: choline, 30.195 +/- 2.448(8.108) and 22.648 +/- 1.938(8.556); trimethylamine, 3.425 +/- 0.335(9.769) and 0.640 +/- 0.066(10.325); sarcosine, 3.425 +/- 0.335(9.769) and 0.640 +/- 0.099(15.394); lactate, 16.388 +/- 1.134(6.922) and 9.715 +/- 0.385(3.965); inositol, 1.970 +/- 0.282(14.334) and 3.859 +/- 0.502(13.020); and taurine, 6.614 +/- 0.556(8.412) and 10.748 +/- 1.206(11.222). High levels of choline (p=0.026), trimethylamine (p=0.001), sarco-sine (p=0.009), and lactate (p=0.009), and lower levels of inositol (p=0.006) and taurine (p=0.008) were char-acteristic findings in cancerous as compared with normal breast tissue, with significantly different results. CONCLUSION: 1H MRS both in vitro and in vivo showed that increased choline levels were present in cancerous breast tissue, but that normal tissue does not contain choline. The presence of choline could therefore be used as a marker for malignancy in breast lesions. Information provided by in vitro 1H MRS, together with the development of in vivo 1H MRS with high field strength and high resolution, may be very useful for the diagnosis of breast cancer.

MR Imaging of Multiple Fibroadenoma in Breast: Comparison with Color Doppler Images and Histologic Findings

PURPOSE: To understand the different signal intensities seen on contrast enhanced magnetic resonance imaging (MRI) in multiple fibroadenoma of the breast, and to compare these with color Doppler ultrasonographic (CDUS) and histologic findings. MATERIALS AND METHODS: MRI (1.0 Tesla, T1WI, T2WI, 3D-gradient echo dynamic contrast enhancement study) findings of 24 histologically proven cases of fibroadenoma in five patients were evaluated and compared with the histologic components (myxoid, adenomatous, fibrous). In addition, vascular flow, as seen on CDUS and histologic section, was compared. RESULTS: The observed degree of signal intensity was classified into three groups, as follows: negative, 8.3%, mild to moderate, 54.2%; marked, 37.5%. On histologic section, the greater the fibrotic component, the higher the intensity of MRI enhancement, the greater the glandular component, and the intensity. CDUS showed vascular flow in only one tumor larger than 3cm in diameter. Vascular patterns of tumors on CDUS were dots in mass and detouring pattern, but in this case and in strongly enhanced cases, tumor vascularity-as seen on histologic section-showed no significant increase. CONCLUSION: Different signal intensities seen on contrast enhanced MRI in multiple fibroadenoma of the breast may be related more to the amount of glandular and fibrotic component than to increased tumor vascularity.

Mammography, US and MR Findings of Cystic Lymphangioma of the Breast: a Case Report

Lymphangiomas are congenital malformations that occur most commonly in the head, neck or axilla and 80-90% of lesions are detected by the age of two years. Cystic lymphangioma of the breast in a 37-year-old woman ; it showed typical well-defined tubular and nodular opacity on mammogram, a multilocular septated anechoic mass on ultrasonogram, and low and high signal intensity on T1- and T2-weighted MR images, respectively. These findings before surgery indicated cystic lymphangioma.