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Conti M, Morciano F, Amodeo S, Gori E, Romanucci G, Belli P, Tommasini O, Fornasa F, Rella R. Special Types of Breast Cancer: Clinical Behavior and Radiological Appearance. J Imaging 2024; 10:182. [PMID: 39194971 DOI: 10.3390/jimaging10080182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/21/2024] [Accepted: 07/23/2024] [Indexed: 08/29/2024] Open
Abstract
Breast cancer is a complex disease that includes entities with different characteristics, behaviors, and responses to treatment. Breast cancers are categorized into subgroups based on histological type and grade, and these subgroups affect clinical presentation and oncological outcomes. The subgroup of "special types" encompasses all those breast cancers with insufficient features to belong to the subgroup "invasive ductal carcinoma not otherwise specified". These cancers account for around 25% of all cases, some of them having a relatively good prognosis despite high histological grade. The purpose of this paper is to review and illustrate the radiological appearance of each special type, highlighting insights and pitfalls to guide breast radiologists in their routine work.
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Affiliation(s)
- Marco Conti
- UOC di Radiologia Toracica e Cardiovascolare, Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Francesca Morciano
- Facoltà di Medicina e Chirurgia, Università Cattolica Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - Silvia Amodeo
- Facoltà di Medicina e Chirurgia, Università Cattolica Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - Elisabetta Gori
- Facoltà di Medicina e Chirurgia, Università Cattolica Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - Giovanna Romanucci
- UOSD Breast Unit ULSS9, Ospedale di Marzana, Piazzale Lambranzi 1, 37142 Verona, Italy
| | - Paolo Belli
- UOC di Radiologia Toracica e Cardiovascolare, Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Facoltà di Medicina e Chirurgia, Università Cattolica Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
| | - Oscar Tommasini
- UOC Diagnostica per Immagini, Dipartimento Emergenza e Accettazione, Ospedale G.B. Grassi, Via Gian Carlo Passeroni, 28, 00122 Rome, Italy
| | - Francesca Fornasa
- UOSD Breast Unit ULSS9, Ospedale di Marzana, Piazzale Lambranzi 1, 37142 Verona, Italy
| | - Rossella Rella
- UOC Diagnostica per Immagini, Dipartimento Emergenza e Accettazione, Ospedale G.B. Grassi, Via Gian Carlo Passeroni, 28, 00122 Rome, Italy
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Invasive Ductal Carcinoma NST and Special Subtypes: Radiology-Pathology Correlation. CURRENT BREAST CANCER REPORTS 2021. [DOI: 10.1007/s12609-021-00436-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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El Khoury M, Maietta A, Tran A, Trop I, Lalonde L, Mesurolle B. Case 285: Primary Breast Lymphoma. Radiology 2021; 298:231-236. [PMID: 33347397 DOI: 10.1148/radiol.2020191329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
History A 25-year-old woman was referred to our breast clinic for assessment of a palpable mass in her left breast that developed quickly in 2 weeks. She denied any associated fever, chills, redness, or pain. She had no relevant medical or surgical history; no evidence of recent pregnancy, abortion, or breastfeeding; and no family history of breast cancer. Clinical examination enabled confirmation of a firm mass occupying the retroareolar region and the outer quadrant of the left breast with no skin retraction, edema, or erythema. There was no evidence of enlarged axillary lymph nodes. US of the left breast, bilateral breast MRI, and fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/CT were performed.
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Affiliation(s)
- Mona El Khoury
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Antonio Maietta
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Alphonse Tran
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Isabelle Trop
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Lucie Lalonde
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
| | - Benoît Mesurolle
- From the Departments of Radiology (M.E.K., I.T., L.L.), Pathology (A.M.), and Nuclear Medicine (A.T.), Centre Hospitalier Universitaire de Montréal (CHUM), 1051 Rue Sanguinet, Montréal, QC, Canada H2X 3H4; and Department of Radiology, McGill University Health Centre, Montréal, Quebec, Canada (B.M.)
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Feliciano YZ, Freire R, Net J, Yepes M. Ductal and lobular carcinoma in situ arising within an enlarging biopsy proven fibroadenoma. BMJ Case Rep 2021; 14:e237017. [PMID: 33468635 PMCID: PMC7817826 DOI: 10.1136/bcr-2020-237017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 01/21/2023] Open
Abstract
The diagnosis via core needle biopsy of concurrent ductal carcinoma in situ and lobular carcinoma in situ within an enlarging previously biopsied benign fibroadenoma in women in their 40s is rare. Several case reports have described the occurrence of malignant changes within fibroadenomas, usually as an incidental finding following excision, and few reports have documented the transition of a fibroadenoma to malignancy. The current case report emphasises the importance of re-biopsying enlarging fibroadenomas, even with otherwise maintained benign appearing features on imaging, in women in their 40s, in order to exclude the possibility of malignancy.
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MESH Headings
- Biopsy, Large-Core Needle
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/therapy
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/therapy
- Female
- Fibroadenoma/pathology
- Humans
- Mammography
- Middle Aged
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Affiliation(s)
- Yara Z Feliciano
- Radiology Department, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Rochelle Freire
- Pathology Department, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jose Net
- Radiology Department, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Monica Yepes
- Radiology Department, University of Miami Miller School of Medicine, Miami, Florida, USA
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Pintican R, Duma M, Chiorean A, Fetica B, Badan M, Bura V, Szep M, Feier D, Dudea S. Mucinous versus medullary breast carcinoma: mammography, ultrasound, and MRI findings. Clin Radiol 2020; 75:483-496. [PMID: 32057415 DOI: 10.1016/j.crad.2019.12.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/31/2019] [Indexed: 12/26/2022]
Abstract
Mucinous and medullary breast cancers (BCs) have different histological substrates that manifest as different imaging features on mammography, ultrasound, and MRI. The aim of the present review is to demonstrate the differences between these two rare BC subtypes and to describe the microscopic features, review the imaging methods for detection of both cancer subtypes, illustrate the imaging findings and present useful pearls and pitfalls. Out of a total of 30 patients with mucinous BC and nine with medullary BC, we have selected typical and also unusual imaging features that best represent these cancers. The patients underwent a mammography and breast ultrasound followed by magnetic resonance imaging. We briefly exhibit histological characteristics for a better understanding of the imaging aspects.
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Affiliation(s)
- R Pintican
- Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; Radiology and Medical Imaging Department, University Hospital, Cluj-Napoca, Romania.
| | - M Duma
- Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; Micromedica Clinic, Piatra Neamt, Romania
| | - A Chiorean
- Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; Medimages Breast Center, Cluj-Napoca, Romania
| | - B Fetica
- Pathology Department, University Hospital, Cluj-Napoca, Romania
| | - M Badan
- Pathology Department, University Hospital, Cluj-Napoca, Romania
| | - V Bura
- Radiology and Medical Imaging Department, University Hospital, Cluj-Napoca, Romania
| | - M Szep
- Medimages Breast Center, Cluj-Napoca, Romania
| | - D Feier
- Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; Medimages Breast Center, Cluj-Napoca, Romania
| | - S Dudea
- Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; Radiology and Medical Imaging Department, University Hospital, Cluj-Napoca, Romania
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Grimm LJ, Enslow M, Ghate SV. Solitary, Well-Circumscribed, T2 Hyperintense Masses on MRI Have Very Low Malignancy Rates. JOURNAL OF BREAST IMAGING 2019; 1:37-42. [PMID: 38424872 DOI: 10.1093/jbi/wby014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVE The purpose of this study was to determine the malignancy rate of solitary MRI masses with benign BI-RADS descriptors. METHODS A retrospective review was conducted of all breast MRI reports that described a mass with a final BI-RADS assessment of 3, 4, or 5, from February 1, 2005, through February 28, 2014 (n = 1510). Studies were excluded if the mass was not solitary, did not meet formal criteria for a mass, or had classically suspicious BI-RADS features (e.g., washout kinetics, and spiculated margin). The masses were reviewed by 2 fellowship-trained breast radiologists who reported consensus BI-RADS mass margin, shape, internal-enhancement, and kinetics descriptors. The T2 signal was reported as hyperintense if equal to or greater than the signal intensity of the axillary lymph nodes. Pathology results or 2 years of imaging follow-up were recorded. Comparisons were made between mass descriptors and clinical outcomes. RESULTS There were 127 women with 127 masses available for analysis. There were 76 (60%) masses that underwent biopsy for an overall malignancy rate of 4% (5/127): 2 ductal carcinoma in situ (DCIS) and 3 invasive ductal carcinoma. The malignancy rate was 2% (1/59) for T2 hyperintense solitary masses. The malignancy rate was greater than 2% for all of the following BI-RADS descriptors: oval (3%, 3/88), round (5%, 2/39), circumscribed (4%, 5/127), homogeneous (4%, 3/74), and dark internal septations (4%, 2/44). CONCLUSION T2 hyperintense solitary masses without associated suspicious features have a low malignancy rate, and they could be considered for a BI-RADS 3 final assessment.
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Affiliation(s)
- Lars J Grimm
- Duke University Medical Center, Department of Radiology, Durham, NC
| | - Michael Enslow
- Duke University Medical Center, Department of Radiology, Durham, NC
| | - Sujata V Ghate
- Duke University Medical Center, Department of Radiology, Durham, NC
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Abstract
Interpretation of 18F-FDG PET/CT studies in breast is challenging owing to nonspecific FDG uptake in various benign and malignant conditions. Benign conditions include breast changes in pregnancy and lactation, gynecomastia, mastitis, fat necrosis, fibroadenoma, intraductal papilloma, and atypical ductal hyperplasia. Among malignancies, invasive ductal carcinoma and invasive lobular carcinoma are common histological types of breast carcinoma. Rarely, other unusual histological types of breast carcinomas (eg, intraductal papillary carcinoma, invasive micropapillary carcinoma, medullary carcinoma, mucinous carcinoma, and metaplastic carcinoma), lymphoma, and metastasis can be the causes. Knowledge of a wide spectrum of hypermetabolic breast lesions on FDG PET/CT is essential in accurate reading of FDG PET/CT. The purpose of this atlas article is to demonstrate features of various breast lesions encountered at our institution, both benign and malignant, which can result in hypermetabolism on FDG PET/CT imaging.
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Larribe M, Thomassin-Piana J, Jalaguier-Coudray A. Breast cancers with round lumps: Correlations between imaging and anatomopathology. Diagn Interv Imaging 2014; 95:37-46. [DOI: 10.1016/j.diii.2013.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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