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Lobular breast cancer series: imaging.

Johnson K, Sarma D, Hwang ES - Breast Cancer Res. (2015)

Bottom Line: However, advances in mammography, ultrasound, and magnetic resonance imaging present opportunities to improve the diagnosis and preoperative assessment of ILC.The evidence supporting the performance of each imaging modality will be reviewed, specifically as it relates to the pathology of ILC and its subtypes.Further, we will discuss emerging technologies that may be employed to enhance the detection rate and ultimately result in more effective screening and staging of ILC.

View Article: PubMed Central - PubMed

Affiliation: Duke Cancer Institute, Duke University Medical Center, 20 Medicine Circle, Durham, NC, 27710, USA.

ABSTRACT
The limitations of mammography in the detection and evaluation of invasive lobular carcinoma (ILC) have long been recognized, presenting real clinical challenges in treatment planning for these tumors. However, advances in mammography, ultrasound, and magnetic resonance imaging present opportunities to improve the diagnosis and preoperative assessment of ILC. The evidence supporting the performance of each imaging modality will be reviewed, specifically as it relates to the pathology of ILC and its subtypes. Further, we will discuss emerging technologies that may be employed to enhance the detection rate and ultimately result in more effective screening and staging of ILC.

No MeSH data available.


Related in: MedlinePlus

A 63-year-old female presented with a palpable mass in the left breast. a,b Mammography showed an irregular mass with partially obscured margins measuring 3.2 cm. (c) Directed ultrasound revealed a hypoechoic mass with irregular borders and posterior acoustic shadowing measuring 3.5 cm in the greatest dimension. d,e Core needle biopsy revealed invasive lobular carcinoma and a staging magnetic resonance image MRI was ordered (c and d). Note the irregular heterogeneously enhancing mass consistent with that seen on mammogram and ultrasound. MRI also revealed multiple smaller, enhancing masses suspicious for satellite lesions (arrows in (d,e)), as well as enlarged abnormal axillary lymphadenopathy (circle in (e)). Mastectomy revealed two adjacent tumors, the larger 5 cm and the smaller 3.5 cm, as well as 5 of 17 axillary nodes positive for metastatic disease
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Fig3: A 63-year-old female presented with a palpable mass in the left breast. a,b Mammography showed an irregular mass with partially obscured margins measuring 3.2 cm. (c) Directed ultrasound revealed a hypoechoic mass with irregular borders and posterior acoustic shadowing measuring 3.5 cm in the greatest dimension. d,e Core needle biopsy revealed invasive lobular carcinoma and a staging magnetic resonance image MRI was ordered (c and d). Note the irregular heterogeneously enhancing mass consistent with that seen on mammogram and ultrasound. MRI also revealed multiple smaller, enhancing masses suspicious for satellite lesions (arrows in (d,e)), as well as enlarged abnormal axillary lymphadenopathy (circle in (e)). Mastectomy revealed two adjacent tumors, the larger 5 cm and the smaller 3.5 cm, as well as 5 of 17 axillary nodes positive for metastatic disease

Mentions: The most common MRI presentation of ILC is that of a mass with irregular or spiculated margins, followed by a non-mass lesion in 20 to 40 % of cases (Fig. 3) [28]. As expected, there is some variation in the imaging characteristics of ILC on MRI. Some studies have shown that absence of smooth margins is a typical feature of ILC; however, other reports have described ILC with smooth margins. The distribution of non-mass-like enhancement on MRI is similarly variable, and ILC may present as ductal, segmental, regional or diffuse patterns [28].Fig. 3


Lobular breast cancer series: imaging.

Johnson K, Sarma D, Hwang ES - Breast Cancer Res. (2015)

A 63-year-old female presented with a palpable mass in the left breast. a,b Mammography showed an irregular mass with partially obscured margins measuring 3.2 cm. (c) Directed ultrasound revealed a hypoechoic mass with irregular borders and posterior acoustic shadowing measuring 3.5 cm in the greatest dimension. d,e Core needle biopsy revealed invasive lobular carcinoma and a staging magnetic resonance image MRI was ordered (c and d). Note the irregular heterogeneously enhancing mass consistent with that seen on mammogram and ultrasound. MRI also revealed multiple smaller, enhancing masses suspicious for satellite lesions (arrows in (d,e)), as well as enlarged abnormal axillary lymphadenopathy (circle in (e)). Mastectomy revealed two adjacent tumors, the larger 5 cm and the smaller 3.5 cm, as well as 5 of 17 axillary nodes positive for metastatic disease
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4499185&req=5

Fig3: A 63-year-old female presented with a palpable mass in the left breast. a,b Mammography showed an irregular mass with partially obscured margins measuring 3.2 cm. (c) Directed ultrasound revealed a hypoechoic mass with irregular borders and posterior acoustic shadowing measuring 3.5 cm in the greatest dimension. d,e Core needle biopsy revealed invasive lobular carcinoma and a staging magnetic resonance image MRI was ordered (c and d). Note the irregular heterogeneously enhancing mass consistent with that seen on mammogram and ultrasound. MRI also revealed multiple smaller, enhancing masses suspicious for satellite lesions (arrows in (d,e)), as well as enlarged abnormal axillary lymphadenopathy (circle in (e)). Mastectomy revealed two adjacent tumors, the larger 5 cm and the smaller 3.5 cm, as well as 5 of 17 axillary nodes positive for metastatic disease
Mentions: The most common MRI presentation of ILC is that of a mass with irregular or spiculated margins, followed by a non-mass lesion in 20 to 40 % of cases (Fig. 3) [28]. As expected, there is some variation in the imaging characteristics of ILC on MRI. Some studies have shown that absence of smooth margins is a typical feature of ILC; however, other reports have described ILC with smooth margins. The distribution of non-mass-like enhancement on MRI is similarly variable, and ILC may present as ductal, segmental, regional or diffuse patterns [28].Fig. 3

Bottom Line: However, advances in mammography, ultrasound, and magnetic resonance imaging present opportunities to improve the diagnosis and preoperative assessment of ILC.The evidence supporting the performance of each imaging modality will be reviewed, specifically as it relates to the pathology of ILC and its subtypes.Further, we will discuss emerging technologies that may be employed to enhance the detection rate and ultimately result in more effective screening and staging of ILC.

View Article: PubMed Central - PubMed

Affiliation: Duke Cancer Institute, Duke University Medical Center, 20 Medicine Circle, Durham, NC, 27710, USA.

ABSTRACT
The limitations of mammography in the detection and evaluation of invasive lobular carcinoma (ILC) have long been recognized, presenting real clinical challenges in treatment planning for these tumors. However, advances in mammography, ultrasound, and magnetic resonance imaging present opportunities to improve the diagnosis and preoperative assessment of ILC. The evidence supporting the performance of each imaging modality will be reviewed, specifically as it relates to the pathology of ILC and its subtypes. Further, we will discuss emerging technologies that may be employed to enhance the detection rate and ultimately result in more effective screening and staging of ILC.

No MeSH data available.


Related in: MedlinePlus