Role of breast magnetic resonance imaging in determining breast as a source of unknown metastatic lymphadenopathy
R S Henry-Tillman1, S E Harms, K C Westbrook
1Department of Surgery, University of Arkansas for Medical Sciences, John L. McClellan Veterans Administration Hospital, Little Rock 72205, USA.
Background:
Occult primary breast cancer (OPBC) represents less than 1% of breast cancer. In only a third of cases, mammography identifies a primary tumor. We hypothesized that rotating delivery of excitation off-resonance breast magnetic resonance imaging (MRI) would identify or exclude the breast as a primary site in patients with OPBC.
Methods:
In a retrospective review, 10 patients were identified with OPBC in which MRI was performed. Malignant appearing lesions were correlated with histopathologic findings at biopsy or surgery.
Results:
MRI identified the primary site in 8 of 10 cases as breast (80%), and excluded it in 2 cases. The extent of disease and location was accurately predicted when compared with histopathologic specimen.
Conclusions:
As we continue to focus on a cure of early breast cancer, it is imperative that diagnostic images become more sensitive and specific. MRI accurately predicted OPBC in this subset of patients.
