A 61-year-old lady with inconclusive conventional imaging finding & sc



Doctor's Information

Name : maryam
Family : noori
Affiliation :radiologist
Academic Degree : M.D
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident :


Case Section

Breast Imaging


Patient's Information

Gender : Female
Age : 61


Clinical Summary

There is no definite finding on conventional imaging with huge breasts, left mastalgia & possibility of mass referring for further evaluation by MRM.


Imaging Findings

On non-contrast images, T2 fat sat & T1, there are some focal asymmetries one of them is prominent mass like at right UIQ. Contrast T1 non-fat sat & subtracted fat sat images show enhancing angulated border mass at right UIQ with rapid rising early kinetic then type II/plateau curve.


Differential Diagnosis



Final Diagnosis

Invasive ductal carcinoma (stage I).


Discussion (Related Text)

Inconclusive finding in conventional imaging is one of indications for breast MRI according the latest guidelines of ACR (2013) & ECR (2008). Other indications are: Preop staging & surgical management Screening contralateral breast in proven BC is valid indication for preop MR Unknown primary cancer, patient with metastasis of unknown origin (lymphadenopathy, liver, lung, bone, brain, etc.) Evaluation of therapy response in neoadjuvant setting. Evaluation after BCT, 3 instances: Residual disease after positive margins, evaluating suspected recurrence, screening tool in patients under 50 lifetime risk is still greater than 20% despite RT. High risk patients>20% lifetime risk (gene testing, Family pedigree, mantel RT for HD) Screening contralateral breast in new malignancy In breast augmentation which mammography is difficult. Prosthesis imaging, any complains (leaking/rupture/extent) Post op screening modality in cancer MR guided biopsy & lesion localization



ACR 2013 ECR 2008.


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