Cancers, Vol. 14, Pages 5786: Staging Breast Cancer with MRI, the T. A Key Role in the Neoadjuvant Setting

Figure 1. A 51-year-old patient with invasive ductal carcinoma (ER 40% PR 3% Ki67 40% HER2 3+) of the upper outer quadrant of the left breast. Pre-NACT CE-MRI revealed an area of non-mass enhancement with segmental distribution in the left breast that extends to pectoralis muscle without signs of invasion (red circle, (a) axial maximum intensity projection reconstruction image; red circle, (b), sagittal post-contrast T1-weighted image). At the end of NACT, CE-MRI showed no residual tumor (pCR) ((c) axial maximum intensity projection reconstruction image; (d) sagittal post-contrast T1-weighted image).

Figure 1. A 51-year-old patient with invasive ductal carcinoma (ER 40% PR 3% Ki67 40% HER2 3+) of the upper outer quadrant of the left breast. Pre-NACT CE-MRI revealed an area of non-mass enhancement with segmental distribution in the left breast that extends to pectoralis muscle without signs of invasion (red circle, (a) axial maximum intensity projection reconstruction image; red circle, (b), sagittal post-contrast T1-weighted image). At the end of NACT, CE-MRI showed no residual tumor (pCR) ((c) axial maximum intensity projection reconstruction image; (d) sagittal post-contrast T1-weighted image).

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Figure 2. A 48-year-old patient with G2, luminal B, HER2 positive right breast cancer undergoing NACT. Pre-treatment breast CE-MRI showed an oval mass with irregular margins, nipple invasion and skin retraction at the junction of upper quadrants of the right breast (red circle, (a) axial maximum intensity projection reconstruction image) (red circle, (b) sagittal post-contrast T1-weighted image). After NACT, multifocal shrinkage was depicted by CE-MRI (red circle (c), axial maximum intensity projection reconstruction image). (d) Signal void artifact caused by tissue marker clip inside the residual mass is well visible on the sagittal T1-weighted post-contrast image (red arrow).

Figure 2. A 48-year-old patient with G2, luminal B, HER2 positive right breast cancer undergoing NACT. Pre-treatment breast CE-MRI showed an oval mass with irregular margins, nipple invasion and skin retraction at the junction of upper quadrants of the right breast (red circle, (a) axial maximum intensity projection reconstruction image) (red circle, (b) sagittal post-contrast T1-weighted image). After NACT, multifocal shrinkage was depicted by CE-MRI (red circle (c), axial maximum intensity projection reconstruction image). (d) Signal void artifact caused by tissue marker clip inside the residual mass is well visible on the sagittal T1-weighted post-contrast image (red arrow).

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Table 1. MRI main features of breast cancer molecular subtype.

Table 1. MRI main features of breast cancer molecular subtype.

Shape and MarginT2 SignalEnhancement PatternOthersLuminal AIrregular, spiculatedLow/isoHeterogenous-Luminal BIrregular, not circumscribedLow/isoHeterogenousMultifocal, multicentric, skin and/or nipple invasionHER2 positive Irregular, not circumscribedLowHeterogenousNon-mass enhancement, peritumoral oedema, tumor necrosisTriple NegativeRound/oval, circumscribedHighRim enhancementPeritumoral oedema, tumor necrosis

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