Lobular breast cancer: How useful is breast magnetic resonance imaging?

Rationale and objectives: To review magnetic resonance imaging (MRI) findin gs in lobular breast carcinoma, the in situ or infiltrating subtype, with s pecial attention to the dynamic curves with the aim to evaluate possible di fferences with ductal carcinoma. Methods: In 2 years, 27 patients with lobular and one with tubular carcinom a underwent MRI at the Istituto Nazionale Tumori of Milan. Results: All lobular carcinomas demonstrated early or late enhancement (100 % sensitivity), without significant differences in morphology compared with ductal carcinoma, but frequently with a different shape of the dynamic cur ves. Conclusions: Due to its infiltrative growth associated to only limited conn ective tissue reaction, lobular carcinoma often encounters difficulties in mammographic diagnosis. In contrast, MRI can be very helpful in evaluating the true extension of the disease, especially when breast conservation is c onsidered. Due to a more consistent fibrotic stroma, these lesions sometime s show a delayed enhancement, which suggests that more than one set of subt racted images should be evaluated during MRI analysis.