Oh Seung Won, Lim Hyo Soon, Moon Sung Min, Kim Jin Woong, Shin Sang Soo, Heo Suk Hee, Lee Ji Shin, Park Min Ho
1 Department of Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea.
2 Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea.
Br J Radiol. 2017 Oct;90(1078):20170203. doi: 10.1259/bjr.20170203. Epub 2017 Aug 22.
To describe the MR imaging characteristics of breast cancer diagnosed during lactation and evaluate the usefulness of MR imaging.
The MR images of nine patients (age range, 29-37 years) with pathologically confirmed breast carcinoma during lactation were evaluated retrospectively. Background parenchymal enhancement of the lactating mammary tissue was determined. The images were reviewed for evaluation of lesion detection, enhancement type (mass/non-mass), shape, margin, contrast enhancement and time-intensity curve pattern in the dynamic study. The breast MR images after neoadjuvant chemotherapy were also reviewed.
Although the breasts showed marked (n = 7) or moderate (n = 2) background parenchymal enhancement, MR imaging depicted breast cancer in all patients. All nine tumours were visible as masses. The most common shape and margin of the masses were an irregular mass (n = 5) with an irregular margin (n = 9). Contrast enhancement was heterogeneous or rim enhancement. The predominant kinetic pattern was rapid increase (n = 9) in the initial phase and washout (n = 5) in the delayed phase. Additional sites of cancer other than the index lesion were detected with MR imaging in three patients (33.3%). MR imaging demonstrated partial response in five of six patients who were evaluated for response to chemotherapy.
All breast cancers in lactating females in this study were observed on breast MR imaging despite the moderate-to-marked background parenchymal enhancement of lactating mammary tissue. Advances in knowledge: MR imaging can be used in the evaluation of disease extent and assessment of therapeutic response after neoadjuvant chemotherapy of breast cancer diagnosed during lactation.
描述哺乳期诊断的乳腺癌的磁共振成像（MR）特征，并评估MR成像的实用性。
回顾性评估9例（年龄范围29 - 37岁）经病理证实为哺乳期乳腺癌患者的MR图像。确定哺乳期乳腺组织的背景实质强化情况。在动态研究中，对图像进行评估以检测病变、强化类型（肿块/非肿块）、形状、边缘、对比增强及时间 - 强度曲线模式。还回顾了新辅助化疗后的乳腺MR图像。
尽管乳腺显示明显（n = 7）或中度（n = 2）的背景实质强化，但MR成像在所有患者中均显示出乳腺癌。所有9个肿瘤均表现为肿块。肿块最常见的形状和边缘分别为不规则肿块（n = 5）和不规则边缘（n = 9）。对比增强为不均匀或边缘强化。主要的动力学模式是初始阶段快速强化（n = 9），延迟阶段廓清（n = 5）。3例患者（33.3%）通过MR成像检测到除索引病变外的其他癌灶。在评估化疗反应的6例患者中，MR成像显示5例有部分反应。
本研究中哺乳期女性的所有乳腺癌在乳腺MR成像中均被观察到，尽管哺乳期乳腺组织有中度至明显的背景实质强化。知识进展：MR成像可用于评估哺乳期诊断的乳腺癌新辅助化疗后的疾病范围及治疗反应评估。
