Des cancers du sein sans signe en mammographie : quand et pourquoi ?

[Breast ultrasonography: an overview]

The most important roles of ultrasound in breast imaging include the diagnosis of cysts and the characterization of masses that have been incompletely assessed by mammography. Ultrasonography techniques such as harmonic and compound imaging have recently been introduced and are more efficient than conventional imaging in terms of lesion conspicuity and the characterization of breast nodule. The BI-RADS classification is an important system for describing and classifying breast lesions. With this approach, a population of benign solid breast lesions that does not require biopsy can be accurately defined. Ultrasonography should be performed as first-line examination in juvenile, in pregnant women and in patients with inflammatory syndrome. Ultrasound can detect mammographically occult breast the way they develop.

[Breast MRI in invasive lobular carcinoma: diagnosis and staging]

PURPOSE

To assess the use of breast MRI for the diagnosis and staging of invasive lobular carcinoma and its impact on surgical management.

MATERIALS AND METHODS

Retrospective study of 35 invasive lobular carcinoma, histologically diagnosed in 34 patients who underwent clinical exam, mammography, ultrasonography and magnetic resonance imaging.

RESULTS

Enhancement at MRI was seen for all 35 cancers. It was focal for 24 patients, regional for 10 and diffuse for 1. The kinetic of the enhancement was characteristic of malignancy for 33 patients. For 11 patients the MRI staging was positive, finding 8 news cancers. For 3 patients MRI lead to biopsy of benign lesions but improved the surgical management in the 8 cases of new cancers: wider excision for 3 cases, planned breast conservation converted to mastectomy in 3 cases and excision of contralateral lesion in 2 cases.

CONCLUSION

Breast MRI is useful in diagnosis, staging and surgical management of invasive lobular breast carcinoma.