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Comparative Study
. 2008 May;18(5):931-8.
doi: 10.1007/s00330-008-0851-y. Epub 2008 Feb 13.

Breast tumor characteristics of BRCA1 and BRCA2 gene mutation carriers on MRI

J Veltman  1 , R Mann, T Kok, I M Obdeijn, N Hoogerbrugge, J G Blickman, C Boetes
Affiliations
Comparative Study

Breast tumor characteristics of BRCA1 and BRCA2 gene mutation carriers on MRI

J Veltman et al. Eur Radiol. 2008 May.

Abstract

The appearance of malignant lesions in BRCA1 and BRCA2 mutation carriers (BRCA-MCs) on mammography and magnetic resonance imaging (MRI) was evaluated. Thus, 29 BRCA-MCs with breast cancer were retrospectively evaluated and the results compared with an age, tumor size and tumor type matched control group of 29 sporadic breast cancer cases. Detection rates on both modalities were evaluated. Tumors were analyzed on morphology, density (mammography), enhancement pattern and kinetics (MRI). Overall detection was significantly better with MRI than with mammography (55/58 vs 44/57, P=0.021). On mammography, lesions in the BRCA-MC group were significantly more described as rounded (12//19 vs 3/13, P=0.036) and with sharp margins (9/19 vs 1/13, P=0.024). On MRI lesions in the BRCA-MC group were significantly more described as rounded (16/27 vs 7/28, P=0.010), with sharp margins (20/27 vs 7/28, P<0.001) and with rim enhancement (7/27 vs 1/28, P=0.025). No significant difference was found for enhancement kinetics (P=0.667). Malignant lesions in BRCA-MC frequently have morphological characteristics commonly seen in benign lesions, like a rounded shape or sharp margins. This applies for both mammography and MRI. However the possibility of MRI to evaluate the enhancement pattern and kinetics enables the detection of characteristics suggestive for a malignancy.

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Figures

Fig. 1
Fig. 1
a An MLO mammogram from the right breast of a 42-year-old BRCA1-mutation carrier. b A coronal subtraction MR image of the same breast. An 11-mm sharply delineated rounded lesion is present on the mammogram projecting over the upper quadrants (arrow). On MRI, the same lesion was detected (arrow) with rim-enhancement. The rim-enhancement makes this lesion morphologically suspect malignant. Ultrasound guided core biopsy proved this lesion to be an invasive duct carcinoma
Fig. 2
Fig. 2
a A coronal subtraction MR image from the right breast of a 49-year-old BRCA1-mutation carrier. Lateral located in the right breast, a sharply delineated rounded, homogeneous enhancing lesion is visible with a longest diameter of 9 mm (arrow). b The relative enhancement versus time curve. The type 3 curve seen for this lesion was the only characteristic indicating a possible malignancy. Pathology proved this lesion to be an invasive duct carcinoma
See this image and copyright information in PMC

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