MR imaging characteristics of breast cancer diagnosed during lactation

Abstract

All breast cancers in lactating females in this study were observed on breast MR imaging despite the moderate-to-marked background parenchymal enhancement of lactating mammary tissue. Advances in knowledge: MR imaging can be used in the evaluation of disease extent and assessment of therapeutic response after neoadjuvant chemotherapy of breast cancer diagnosed during lactation.

Breast imaging screening in a BRCA1-mutated lactating patient: A potential pitfall mimicking malignancy

“…MRI assessment of PABC during lactation is controversial and limited by a high number of false positives. Lactating parenchyma shows rapid and marked gadolinium uptake similar to that seen in malignancies, attributed to increased vascularity and vascular permeability [4] . BP is the normal contrast enhancement of fibroglandular breast tissue.…”

“…BP is the normal contrast enhancement of fibroglandular breast tissue. The level of global BPE is assessed in four BI-RADS categories: minimal (<25% of glandular tissue enhanced), mild (25%-50% of glandular tissue enhanced), moderate (50%-75% of glandular tissue enhanced) and marked (>75% of glandular tissue enhanced) [4] . It is generally mild, bilateral, symmetric, with diffuse distribution; however, it may be marked, unilateral, asymmetric and these atypical patterns of BPE cause diagnostic difficulties because these morphology and temporal degree can be seen with non-mass enhancement (NME) malignancies [5] .…”

“…However, Oh et al. [4] suggested confounders such as increased BPE and T2 signal: in these patients, if cancer does not appear as a lump – i.e., low-signal-intensity mass on T2 weighted images – it can be difficult to recognize a malignancy. As reported by Sabate et al.…”