MRI of the breast in patients with metastatic disease of unknown primary

Abstract

The objective of this study was to assess the value of contrast-enhanced dynamic breast imaging in patients with carcinoma of unknown primary (CUP). Fourteen patients presenting with metastatic disease compatible with breast cancer (axillary lymph node metastasis: n = 6; supraclavicular lymph node metastasis: n = 1; bone metastasis: n = 3; liver metastasis: n = 3; lung metastasis: n = 1), who had no evidence of tumor in X-ray mammograms and ultrasound, underwent bilateral dynamic breast MR imaging. Suspicious lesions were localized preoperatively using a stereotactic device for MR-guided localization procedures. Magnetic resonance imaging revealed suspicious lesions in 9 of 14 patients. Histopathology revealed invasive carcinoma of the breast in 6 of these patients. Two enhancing lesions were fibroadenomas; one proved to be sclerosing adenosis. In 5 patients MR imaging showed no abnormality. Follow-ups performed up to 1 year after initial treatment revealed no breast cancers in these 5 patients. In patients with metastatic disease of unknown primary, MRI of the breast depicts the primary in a considerable number of cases with normal conventional evaluation.

Carboplatin, doxorubicin and etoposide in the treatment of tumours of unknown primary site

“…Newer imaging techniques (Tilanus-Linthorst et al, 1997; Kole et al, 1998;Lenzi et al, 1998;Schorn et al, 1999;Stevens et al, 1999), such as breast MRI, positron emission tomography and other nuclear medicine techniques, that can give clues as to the site of the primary, presently remain of limited help.…”

International investigation of breast MRI: results of a multicentre study (11 sites) concerning diagnostic parameters for contrast-enhanced MRI based on 519 histopathologically correlated lesions

“…An increasing number of authors have confirmed the value of contrast-enhanced (CE) MRI for certain indications [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. However, accuracy data in the literature vary, and concern exists that a widespread use of CE MRI combined with insufficient standardization might cause costly work-up and unsatisfying results including false-positive and false-negative results.…”

Near‐infrared imaging of breast cancer using optical contrast agents

“…In optical mammography, analysis of early and very early contrast enhancement is of interest for the following reasons: 1) Despite ongoing technical developments in MR imaging, the temporal resolution achieved is still lower than that of optical techniques [88,89]. 2) The contrast agent ICG differs from gadolinium-DTPA in terms of distribution in different compartments as ICG acts as blood-pool contrast due to strong protein binding ; this difference results from the strong protein binding of ICG, which makes ICG a bloodpool contrast agent [90].…”