The Italian College of Breast Radiologists by the Italian Society of Medical Radiology (SIRM) provides recommendations for breast care provision and procedural prioritization during COVID-19 pandemic, being aware that medical decisions must be currently taken balancing patient's individual and community safety: (1) patients having a scheduled or to-be-scheduled appointment for in-depth diagnostic breast imaging or needle biopsy should confirm the appointment or obtain a new one; (2) patients who have suspicious symptoms of breast cancer (in particular: new onset palpable nodule; skin or nipple retraction; orange peel skin; unilateral secretion from the nipple) should request non-deferrable tests at radiology services; (3) asymptomatic women performing annual mammographic follow-up after breast cancer treatment should preferably schedule the appointment within 1 year and 3 months from the previous check, compatibly with the local organizational conditions; (4) asymptomatic women who have not responded to the invitation for screening mammography after the onset of the pandemic or have been informed of the suspension of the screening activity should schedule the check preferably within 3 months from the date of the not performed check, compatibly with local organizational conditions. The Italian College of Breast Radiologists by SIRM recommends precautions to protect both patients and healthcare workers (radiologists, radiographers, nurses, and reception staff) from infection or disease spread on the occasion of breast imaging procedures, particularly mammography, breast ultrasound, breast magnetic resonance imaging, and breast intervention procedures.

Delayed enhancement and MPD stenosis are suggestive for AIP on MR and MRCP imaging. Secretin-enhanced MRCP is a problem-solving tool in the differential diagnosis between focal AIP and ductal adenocarcinoma.

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Purpose. This study was done to verify the usefulness of preoperative breast magnetic resonance (MR) imaging in patients with newly diagnosed breast cancer. Materials and methods. A retrospective analysis of 291 patients with invasive breast cancer newly diagnosed with conventional breast imaging (mammography and ultrasound) was performed. All patients underwent MR imaging prior to surgery. The MR imaging detection rate of additional malignant cancers occult to mammography and ultrasound was calculated. Data were analysed with Fisher's exact test (p<0.05) according to the following parameters: histopathological features of the index tumour (histological type and size) and mammographic density [according to the Breast Imaging Reporting and Data System (BI-RADS) classification from 1 fatty to 4 dense). The gold standard was the histological examination on the surgical specimen. Results. MR imaging identified 40 mammographically and sonographically occult malignant lesions other than the index cancer in 27/291 patients (9%). These additional cancers were located in the same quadrant as the index cancer in 13 women (4%), in a different quadrant in 12 (4%) and in the contralateral breast in the remaining two (1%). The cancer detection rate in the subgroup of index cancers with lobular histological type was 25%, significantly higher (p=0.03) than the detection rate of 11% recorded in the subgroup of ductal cancers. The cancer detection rate in the subgroup of index cancers >2 cm was 27%, significantly higher (p=0.001) than the rate of 8% found in the subgroup of index cancers <2 cm. RiassuntoObiettivo. Verificare l'utilità dell'esecuzione della risonanza magnetica (RM) mammaria preoperatoria in pazienti con carcinoma invasivo della mammella. Materiali e metodi. Sono state analizzate retrospettivamente 291 pazienti con carcinoma invasivo della mammella sottoposte a mammografia, ecografia e RM prima di intervento chirurgico. È stato calcolato il tasso diagnostico aggiuntivo di lesioni maligne sincrone rispetto al tumore principale identificate dalla sola RM, occulte alla mammografia e all'ecografia. I dati sono stati analizzati con il test esatto di Fisher (p<0,05) secondo i seguenti parametri: caratteri istologici della lesione principale (istotipo tumorale e dimensione), densità mammografica (classificazione Breast Imaging Reporting and Data System [BI-RADS] in categorie da 1=adiposa a 4=densa). Il gold standard è stato l'esame istologico del pezzo operatorio. Risultati. L'indagine RM ha diagnosticato 40 lesioni maligne sincrone in 27/291 Pazienti (tasso diagnostico: 9%). Le lesioni maligne identificate dalla RM erano nello stesso quadrante rispetto alla lesione principale in 13 pazienti (4%), interessavano un altro quadrante in 12 pazienti (4%) e la mammella controlaterale nei rimanenti 2 pazienti (1%). Una correlazione significativa positiva (p=0,03) è emersa tra il tasso di identificazione RM di lesione maligna e istotipo lobulare del carcinoma principale (lesioni maligne sincrone sono state rilevate nel 25% dei tum...

When lesions close to the skin or pectoral muscle are excluded, 3T H-MRS of mass lesions ≥1 cm showed a high diagnostic performance, however, insufficient to avoid needle biopsy.