Inflammatory Breast Carcinoma in Magnetic Resonance Imaging. A Comparison with Locally Advanced Breast Cancer

Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena, Erlanger Allee 101, Jena, Germany.
Academic Radiology (Impact Factor: 1.75). 03/2008; 15(2):209-21. DOI: 10.1016/j.acra.2007.09.011
Source: PubMed


Although inflammatory breast carcinoma (IBC) accounts for 1%-4% of all breast cancer cases, the appearance of this highly malignant tumor in magnetic resonance imaging (MRI) is still not well characterized. The aim of this study was to identify typical imaging features of IBC in comparison with noninflammatory locally advanced breast carcinoma (LABC).
MRIs of 48 patients with IBC were compared with an equivalent cohort of 52 subjects with LABC. Age and histopathologic subtype were equivalent between the two groups. To delineate characteristic features, a multitude of dynamic and morphologic parameters were evaluated using T1- and T2-weighted sequences.
No significant differences of prevalences could be found for the following criteria: dynamic tumor signal characteristics, prominent vessels, perifocal edema, axillary lymph node involvement, morphology of focal masses, and morphologic pattern of non-mass like enhancement. Otherwise, the quantity of focal masses and the spatial distribution of the tumoral infiltration significantly differed between the two cancer groups. The following parameters occurred more frequently in the IBC cases: edema (cutaneous/subcutaneous 81.3%, perimamillar 70.8%, diffuse 89.6%, prepectoral 72.9%, intramuscular pectoral 41.7%), thickening (75.0%) and pathologic enhancement (60.4%) of Cooper's ligaments, skin thickening (83.3%), punched-out sign (initially strong, focal increase of some dermal or subcutaneous parts followed by slow-continuous enhancement of the surrounding skin; 56.3%).
Inflammatory breast carcinoma seems to represent a specific biological entity resulting in typical MRI characteristics. Some of the parameters are supposed to visualize the characteristic extensive lymphovascular infiltration and therefore may improve the diagnosis of IBC.

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    • "This cancer is typically associated with thickening of the overlying skin as can often be seen on MRI images; and this radiological sign constitutes a marker for diagnosing IBC. The abnormal skin also typically has a large water signal.18 Diffuse signal enhancement is expected for this type of cancer as the associated inflammation has related edema; this is evident in the photomicrograph as ‘separation artifacts’ in the tissue slice. "
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    Magnetic Resonance Insights 04/2013; 6:33-49. DOI:10.4137/MRI.S10640
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    • "Néanmoins, quand l'interrogatoire n'apparaît pas fiable, des arguments morphologiques tels que la présence à la mammographie de masses volumineuses et de calcifications extensives peuvent être utilisés. De nombreux auteurs se sont également penchés sur les caractéristiques différentielles de ces deux pathologies à l'IRM [18] [19], ce qui a permis d'identifier des caractéristiques très différentes de ces deux pathologies, jusqu'ici souvent confondues. "
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    • "Nevertheless, when the patient's answers to questions do not seem to be reliable, decisive morphological aspects can be used, such as the presence on the mammogram of voluminous masses and extensive calcifications . Many authors have also looked into the differential characteristics of these two conditions with MRI [18] [19], which has identified very different imaging characteristics for these two diseases that have often been confused in the past. "
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