MRI of the breast in patients with metastatic disease of unknown primary

The objective of this study was to assess the value of contrast-enhanced dy namic breast imaging in patients with carcinoma of unknown primary (CUP). F ourteen patients presenting with metastatic disease compatible with breast cancer (axillary lymph node metastasis: n = 6; supraclavicular lymph node m etastasis: n = 1; bone metastasis: n = 3; liver metastasis: n = 3; lung met astasis: n = 1), who had no evidence of tumor in X-ray mammograms and ultra sound, underwent bilateral dynamic breast MR imaging. Suspicious lesions we re localized preoperatively using a stereotactic device for MR-guided local ization procedures. Magnetic resonance imaging revealed suspicious lesions in 9 of 14 patients. Histopathology revealed invasive carcinoma of the brea st in 6 of these patients. Two enhancing lesions were fibroadenomas; one pr oved to be sclerosing adenosis. In 5 patients MR imaging showed no abnormal ity. Follow-ups performed up to 1 year after initial treatment revealed no breast cancers in these 5 patients. In patients with metastatic disease of unknown primary, MRI of the breast depicts the primary in a considerable nu mber of cases with normal conventional evaluation.