Huong Thien Le-Petross MD, Presenter: Nothing to Disclose

Chusilp Charnsangavej MD, Abstract Co-Author: Nothing to Disclose

Massimo Cristofanilli MD, Abstract Co-Author: Nothing to Disclose

Qing Yuan PhD, Abstract Co-Author: Nothing to Disclose

Wei Tse Yang MD, Abstract Co-Author: Nothing to Disclose

IBC is an aggressive cancer that is most likely a heterogeneous group of disease, having variable imaging characteristics. We retrospectively reviewed medical records and MRI exams of patients diagnosed with IBC at our institution to assess the morphology and kinetic characteristics of the affected breast in these patients.

Women enrolled in an IRB-approved IBC registry at our institution were included in this study if they had MRI performed at diagnosis. The MRI exams were performed on either a 1.5-Tesla (T) or 3.0-T GE scanner using 3D T1-weighted gradient echo gadolinium-enhanced sequences with parallel imaging. Exams were reviewed by one radiologist and the findings described according to the ACR BI-RADS MRI Lexicon.

Thirty-nine women (median age 50 years, range, 25 to 72 years) diagnosed with IBC who had staging MRI performed were included. MRI showed abnormal breast parenchymal enhancement in all (100%) patients. Enhancement was mass-like in 72% of patients, and non mass-like in 28%. The most frequent morphologic abnormalities were irregular margins (82%) and heterogeneous internal enhancement (75%). Architectural distortion was more frequently associated with mass-like (69%) than with non mass-like lesions (31%). Qualitative analysis of the enhancement pattern showed a wash-out or plateau curve in 97% of patients. Skin thickening and heterogeneous skin enhancement were seen in 90% of patients; average skin thickness was 8.5 mm (range, 4-17 mm). Nodular or irregular skin lesions that demonstrated progressive enhancing pattern were identified in 44%.

MRI demonstrates abnormal breast parenchymal enhancements in all patients with IBC. Irregular margins and heterogeneous internal enhancement are the most frequent morphologic features. Heterogeneous skin enhancement, with a progressive enhancing pattern, was more commonly seen than enhancing skin lesions.

The combination of morphology and enhancement patterns on MRI, in IBC patients, may help us to understand the biology of this disease and identify features that may be used as prognostic markers.

Le-Petross, H, Charnsangavej, C, Cristofanilli, M, Yuan, Q, Yang, W, Inflammatory Breast Cancer (IBC): Magnetic Resonance Imaging (MRI) Characteristics at 1.5 and 3.0T.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5013293.html