Abstract
Purpose. To determine the value of MR imaging in the detection and measurement of tumor size in patients with invasive lobular carcinoma (ILC) compared to mammography and ultrasound.
Materials and methods. From 36 cases of ILC in 34 patients who were surgically treated, the pre-operative imaging measurements, being mammography, ultrasound and contrast enhanced MR, were retrospectively re-evaluated for tumor detection and size. Findings were compared with pathology. Two radiologists were used for evaluation of the mammograms, the other imaging modalities were only evaluated by one radiologist. The Pearsons correlation test was used to determine the correlation between histopathological and imaging measurements for each imaging modality.
Results. For mammography, ultrasound and MRI the false negative scores were respectively 14%, 3% and 0%. The percentage for underestimated, correctly estimated and overestimated measurements on imaging were 56%, 33% and 11% for radiologist 1 and 50%, 33% and 17% for radiologist 2 on mammography. For ultrasound and MRI these percentages were respectively 53%, 47%, 0% and 14%, 75%, 11%. The correlation coefficients for mammography were respectively r= 0.34 (p < 0.05) and r= 0.27 (p > 0.05) for both radiologists, for Ultrasound r= 0.24 (p > 0.05) and for MRI r= 0.81 (p < 0.01).
Conclusion. Of the three imaging modalities contrast enhanced MR has the lowest false negative rate in detecting ILC and has the highest accuracy in measuring the size of the ILC. MR could play a key role in the pre-operative work-up for accurate tumor size determination.
Similar content being viewed by others
References
Fisher B, Redmond C, Fisher ER: The contribution of recent NSABP clinical trials of primary breast cancer therapy to an understanding of tumor biology - an overview of findings. Cancer 46: 1009–1025, 1980
Newstead GM, Baute PB, Toth HK: Invasive lobular and ductal carcinoma: mammographic findings and stage at diagnosis. Radiology 184: 623–627, 1992
Krecke KN, Gisvold JJ: Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. AJR Am J Roentgenol 161: 957–960, 1993
Hilleren DJ, Andersson IT, Lindholm K, Linnell FS: Invasive lobular carcinoma: mammographic findings in a 10-year experience. Radiology 178: 149–154, 1991
Holland R, Hendriks JH, Mravunac M: Mammographically occult breast cancer. A pathologic and radiologic study. Cancer 52: 1810–1819, 1983
Paramagul CP, Helvie MA, Adler DD: Invasive lobular carcinoma: sonographic appearance and role of sonography in improving diagnostic sensitivity. Radiology 195: 231–234, 1995
Butler RS, Venta LA, Wiley EL, Ellis RL, Dempsey PJ, Rubin E: Sonographic evaluation of infiltrating lobular carcinoma. AJR Am J Roentgenol 172: 325–330, 1999
Orel SG, Schnall MD, Powell CM, Hochman MG, Solin LJ, Fowble BL, Torosian MH, Rosato EF: Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. Radiology 196: 115–122, 1995
Morris EA, Schwartz LH, Dershaw DD, van Zee KJ, Abramson AF, Liberman L: MR imaging of the breast in patients with occult primary breast carcinoma. Radiology 205: 437–440, 1997
Mumtaz H, Hall C, Davidson T, Walmsley K, Thurell W, Kissin MW, Taylor I: Staging of symptomatic primary breast cancer with MR imaging. AJR Am J Roentgenol 169: 417–424, 1997
Fischer U, Kopka L, Grabbe E: Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology 213: 881–888, 1999
Rodenko GN, Harms SE, Pruneda JM, Farrell RS Jr, Evans WP, Copit DS, Krakos PA, Flamig DP: MR imaging in the management before surgery of lobular carcinoma of the breast: correlation with pathology. AJR Am J Roentgenol 167: 1415–1419, 1996
Weinstein SP, Orel SG, Heller R, Reynolds C, Czerniecki B, Solin LJ, Schnall M: MR imaging of the breast in patients with invasive lobular carcinoma. AJR Am J Roentgenol 176: 399–406, 2001
Gribbestad IS, Nilsen G, Fjosne H, Fougner R, Haugen OA, Petersen SB, Rinck PA, Kvinnsland S: Contrast-enhanced magnetic resonance imaging of the breast. Acta Oncol 31: 833–842, 1992
Harms SE, Flamig DP, Evans WP, Harries SA, Brown S: MR imaging of the breast: current status and future potential. AJR Am J Roentgenol 163: 1039–1047, 1994
Amano G, Ohuchi N, Ishibashi T, Ishida T, Amari M, Satomi S: Correlation of three-dimensional magnetic resonance imaging with precise histopathological map concerning carcinoma extension in the breast. Breast Cancer Res Treat 60: 43–55, 2000
Davis PL, Staiger MJ, Harris KB, Ganott MA, Klementaviciene J, McCarty KS Jr, Tobon H: Breast cancer measurements with magnetic resonance imaging, ultrasonography, and mammography. Breast Cancer Res Treat 37: 1–9, 1996
Boetes C, Mus RD, Holland R, Barentsz JO, Strijk SP, Wobbes T, Hendriks JH, Ruys SH: Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology 197: 743–747, 1995
Fobben ES, Rubin CZ, Kalisher L, Dembner AG, Seltzer MH, Santoro EJ: Breast MR imaging with commercially available techniques: radiologic-pathologic correlation. Radiology 196: 143–152, 1995
Schnitt SJ, Abner A, Gelman R, Connolly JL, Recht A, Duda RB, Eberlein TJ, Mayzel K, Silver B, Harris JR: The relationship between microscopic margins of resection and the risk of local recurrence in patients with breast cancer treated with breast-conserving surgery and radiation therapy. Cancer 74: 1746–1751, 1994
DiBiase SJ, Komarnicky LT, Schwartz GF, Xie Y, Mansfield CM: The number of positive margins influences the outcome of women treated with breast preservation for early stage breast carcinoma. Cancer 82: 2212–2220, 1998
Smitt MC, Nowels KW, Zdeblick MJ, Jeffrey S, Carlson RW, Stockdale FE, Goffinet DR: The importance of the lumpectomy surgical margin status in long-term results of breast conservation. Cancer 76: 259–267, 1995
Mariani L, Salvadori B, Marubini E, Conti AR, Rovini D, Cusumano F, Rosolin T, Andreola S, Zucali R, Rilke F, Veronesi U: Ten year results of a randomised trial comparing two conservative treatment strategies for small size breast cancer. Eur J Cancer 34: 1156–1162, 1998
Veronesi U, Salvadori B, Luini A, Greco M, Saccozzi R, del Vecchio M, Mariani L, Zurrida S, Rilke F: Breast conservation is a safe method in patients with small cancer of the breast. Long-term results of three randomised trials on 1973 patients. Eur J Cancer 31A: 1574–1579, 1995
Egan RL: Multicentric breast carcinomas: clinical-radiographic-pathologic whole organ studies and 10-year survival. Cancer 49: 1123–1130, 1982
Adler OB, Engel A: Invasive lobular carcinoma. Mammographic pattern. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 152: 460–462, 1990
Ma L, Fishell E, Wright B, Hanna W, Allan S, Boyd NF: Case-control study of factors associated with failure to detect breast cancer by mammography. J Natl Cancer Inst 84: 781–785, 1992
Tresserra F, Feu J, Grases PJ, Navarro B, Alegret X, Fernandez-Cid A: Assessment of breast cancer size: sonographic and pathologic correlation. J Clin Ultrasound 27: 485–491, 1999
Finlayson CA, MacDermott TA: Ultrasound can estimate the pathologic size of infiltrating ductal carcinoma. Arch Surg 135: 158–159, 2000
Kaiser WA: MRM promises earlier breast cancer diagnosis. Diagn Imaging (San Franc) 14: 88–93, 1992
Allgayer B, Lukas P, Loos W, Kersting-Sommerhoff B: [The MRT of the breast with 2D-spin-echo and gradient-echo sequences in diagnostically problematic cases]. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 158: 423–427, 1993
Boetes C, Strijk SP, Holland R, Barentsz JO, Van Der Sluis RF, Ruijs JH: False-negative MR imaging of malignant breast tumors. Eur Radiol 7: 1231–1234, 1997
Kristoffersen WM, Aspelin P, Perbeck L, Bone B: Value of MR imaging in clinical evaluation of breast lesions. Acta Radiol 43: 275–281, 2002
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Boetes, C., Veltman, J., van Die, L. et al. The Role of MRI in Invasive Lobular Carcinoma. Breast Cancer Res Treat 86, 31–37 (2004). https://doi.org/10.1023/B:BREA.0000032921.10481.dc
Issue Date:
DOI: https://doi.org/10.1023/B:BREA.0000032921.10481.dc