[Diagnosis of breast cancer extent and enhancement patterns using 3D-dynamic MR imaging: correlation with intraductal...

The usefulness of 3D-dynamic MR imaging with fat suppression and magnetization transfer contrast for assessing breast cancer extent and tumor profile was evaluated in 74 breasts with 67 malignant and 7 benign lesions. We classified breast cancer by the intraductal component of the main tumor. Five histological types were assigned: type 1 (DS 0) invasive carcinoma without intraductal component, type 2 (DS 1): intraductal component is less than 50% of whole tumor, type 3 (DS 2): intraductal component is nearly equal to 50%, type 4 (DS 3): intraductal component is more than 50%, type 5 (DS 4): pure DSIC or DCIS associated with microinvasive foci. Histologic results and preoperative MR imaging were analyzed regarding tumor size and enhancement pattern for the various tumor types (DS 0, 1, 2, 3 and 4). The three tumors occult to MR imaging were two DCIS and one Paget's disease. The other 64 breast cancers were detected on MR imaging. Tumor size measured with MR imaging correlated closely with histologic measurement in DS 0, 1 and 2, whereas less accuracy was noted in DS 3 and 4. Rapid enhancement was frequently seen in DS 0, 1, 2 and 3. Peripheral enhancement was highly specific for breast cancer. However, peripheral enhancement was not found in all cases of DS 4. Linear and nodular enhancement was frequently seen in DS 3 and 4. MR imaging was useful in predicting the intraductal component.