MR-IMAGING IN THE MANAGEMENT BEFORE SURGERY OF LOBULAR CARCINOMA OF THE BREAST - CORRELATION WITH PATHOLOGY

OBJECTIVE, Our objective was to investigate the use of MR imaging in p reoperative staging and characterization of lobular carcinoma. MATERIA LS AND METHODS. MR imaging studies and mammographic studies in 20 pati ents with infiltrating lobular carcinoma were evaluated and correlated with pathology findings on serially sectioned tissue. The MR images a nd mammograms were reviewed retrospectively by three independent exami ners unaware of the clinical, imaging, and pathology findings. RESULTS . The extent of disease found pathologically correlated with that pred icted by MR imaging studies in 85% of patients, compared with a 32% co rrelation (p < .0001) with mammographic studies. Interobserver agreeme nt on lesion morphology and extent of disease was higher for MR imagin g (91% and 100%, respectively) than for mammography (64% and 91%, resp ectively). The retrospective MR readings did not differ from the prosp ective reports. No false-positive lymphadenopathy was interpreted on M R imaging. Lymph nodes having metastatic lobular carcinoma on the path ology examination were missed on MR imaging in four patients. CONCLUSI ON. MR imaging is significantly more accurate than mammography in dete rmining the extent of disease and characterizing the morphology of inf iltrating lobular carcinoma. MR imaging may play a role in preoperativ e planning, especially when breast conservation is being considered.