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Multifocal, Multicentric, and Contralateral Breast Cancers: Bilateral Whole-Breast US in the Preoperative Evaluation of Patients¹

¹ From the Departments of Radiology (W.K.M., J.G.I.) and Surgery (D.Y.N.), Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744, Korea. From the 2000 RSNA scientific assembly. Received July 18, 2001; revision requested September 11; revision received October 9; accepted November 12. Supported by grant HMP-00-P-14-006 from the Korea Health 21 R&D Project, Ministry of Health and Welfare, Republic of Korea. Address correspondence to W.K.M. (e-mail: moonwk@radcom.snu.ac.kr).

View larger version (64K): [in a new window]   Figure 1a. Images in a 54-year-old woman with multicentric carcinoma. (a) Craniocaudal screening mammogram shows a 12-mm spiculated mass (arrow) in the inner portion of the right breast. (b) Radial US image of the inner portion of the same breast shows a hypoechoic mass (arrow) with an ill-defined margin that corresponds to the mammographic finding. (c) Radial US image of the outer portion of the same breast shows an additional 7-mm partially circumscribed (small arrow) and partially ill-defined (large arrow) hypoechoic mass. US-guided core needle biopsy and hook wire-guided surgical excision were performed in both lesions. Histopathologic analysis revealed infiltrating ductal carcinoma at the inner breast and DCIS, papillary type, at the outer breast.

View larger version (117K): [in a new window]   Figure 1b. Images in a 54-year-old woman with multicentric carcinoma. (a) Craniocaudal screening mammogram shows a 12-mm spiculated mass (arrow) in the inner portion of the right breast. (b) Radial US image of the inner portion of the same breast shows a hypoechoic mass (arrow) with an ill-defined margin that corresponds to the mammographic finding. (c) Radial US image of the outer portion of the same breast shows an additional 7-mm partially circumscribed (small arrow) and partially ill-defined (large arrow) hypoechoic mass. US-guided core needle biopsy and hook wire-guided surgical excision were performed in both lesions. Histopathologic analysis revealed infiltrating ductal carcinoma at the inner breast and DCIS, papillary type, at the outer breast.

View larger version (120K): [in a new window]   Figure 1c. Images in a 54-year-old woman with multicentric carcinoma. (a) Craniocaudal screening mammogram shows a 12-mm spiculated mass (arrow) in the inner portion of the right breast. (b) Radial US image of the inner portion of the same breast shows a hypoechoic mass (arrow) with an ill-defined margin that corresponds to the mammographic finding. (c) Radial US image of the outer portion of the same breast shows an additional 7-mm partially circumscribed (small arrow) and partially ill-defined (large arrow) hypoechoic mass. US-guided core needle biopsy and hook wire-guided surgical excision were performed in both lesions. Histopathologic analysis revealed infiltrating ductal carcinoma at the inner breast and DCIS, papillary type, at the outer breast.

View larger version (106K): [in a new window]   Figure 2a. Images in a 58-year-old woman with synchronous bilateral carcinoma. (a) Mediolateral oblique mammogram shows a 45-mm spiculated mass (arrow) with pleomorphic microcalcifications in the central portion of the right breast. (b) Antiradial US image of the right breast shows an irregular heterogeneous mass found in an area that was thought to be suspicious at palpation. Punctate echogenic dots (arrowheads) within the mass are probably due to the calcifications. (c) Mediolateral oblique mammogram obtained after US-guided needle localization shows no definite mammographic lesion in the left breast. Histopathologic analysis revealed infiltrating ductal carcinoma in the right breast and microinvasive carcinoma (ie, DCIS with microinvasion) in the left breast. (d) Radial US image of the left breast shows a 6-mm ill-defined hypoechoic mass (arrows) with mild posterior shadowing.

View larger version (141K): [in a new window]   Figure 2b. Images in a 58-year-old woman with synchronous bilateral carcinoma. (a) Mediolateral oblique mammogram shows a 45-mm spiculated mass (arrow) with pleomorphic microcalcifications in the central portion of the right breast. (b) Antiradial US image of the right breast shows an irregular heterogeneous mass found in an area that was thought to be suspicious at palpation. Punctate echogenic dots (arrowheads) within the mass are probably due to the calcifications. (c) Mediolateral oblique mammogram obtained after US-guided needle localization shows no definite mammographic lesion in the left breast. Histopathologic analysis revealed infiltrating ductal carcinoma in the right breast and microinvasive carcinoma (ie, DCIS with microinvasion) in the left breast. (d) Radial US image of the left breast shows a 6-mm ill-defined hypoechoic mass (arrows) with mild posterior shadowing.

View larger version (100K): [in a new window]   Figure 2c. Images in a 58-year-old woman with synchronous bilateral carcinoma. (a) Mediolateral oblique mammogram shows a 45-mm spiculated mass (arrow) with pleomorphic microcalcifications in the central portion of the right breast. (b) Antiradial US image of the right breast shows an irregular heterogeneous mass found in an area that was thought to be suspicious at palpation. Punctate echogenic dots (arrowheads) within the mass are probably due to the calcifications. (c) Mediolateral oblique mammogram obtained after US-guided needle localization shows no definite mammographic lesion in the left breast. Histopathologic analysis revealed infiltrating ductal carcinoma in the right breast and microinvasive carcinoma (ie, DCIS with microinvasion) in the left breast. (d) Radial US image of the left breast shows a 6-mm ill-defined hypoechoic mass (arrows) with mild posterior shadowing.

View larger version (146K): [in a new window]   Figure 2d. Images in a 58-year-old woman with synchronous bilateral carcinoma. (a) Mediolateral oblique mammogram shows a 45-mm spiculated mass (arrow) with pleomorphic microcalcifications in the central portion of the right breast. (b) Antiradial US image of the right breast shows an irregular heterogeneous mass found in an area that was thought to be suspicious at palpation. Punctate echogenic dots (arrowheads) within the mass are probably due to the calcifications. (c) Mediolateral oblique mammogram obtained after US-guided needle localization shows no definite mammographic lesion in the left breast. Histopathologic analysis revealed infiltrating ductal carcinoma in the right breast and microinvasive carcinoma (ie, DCIS with microinvasion) in the left breast. (d) Radial US image of the left breast shows a 6-mm ill-defined hypoechoic mass (arrows) with mild posterior shadowing.