Images obtained in an 85-year-old female patient with a new biopsy-proven malignant lesion in the right breast. (IMAGE)
Caption
Images obtained in an 85-year-old female patient with a new biopsy-proven malignant lesion in the right breast. (A) The malignant lesion corresponds with a 3.0-cm equal-density mildly irregular mass on right craniocaudal mammogram. US-guided core-needle biopsy revealed grade 3 invasive intracystic papillary carcinoma. (B) Right positron emission mammographic (PEM) craniocaudal color image obtained 1 hour after intravenous injection of 74 MBq of fluorine 18–labeled fluorodeoxyglucose (18F-FDG) shows a 3.2-cm mass (known cancer) with intense uptake. Left PEM (C) mediolateral oblique and (D) craniocaudal color images obtained 1 hour after intravenous injection of 74 MBq of 18F-FDG do not show any abnormal uptake. Right PEM craniocaudal images obtained (E) 1 hour and (F) 4 hours after intravenous injection of 74 MBq of 18F-FDG show no substantial visual difference in uptake of the known cancer. (G, H) Axial contrast-enhanced fat-saturated subtracted T1-weighted MR images with maximum intensity projection reconstruction obtained 90 seconds after intravenous injection of 0.1 mmol of gadolinium-based contrast material per kilogram of body weight also show the enhancing mass corresponding to known malignancy and multiple nonspecific foci of enhancement in the contralateral breast, the largest in the left central breast with washout kinetics (arrow in H). Left-sided MRI-guided biopsy confirmed benign intraductal papilloma. The patient underwent a right lumpectomy with sentinel lymph node biopsy. The final pathologic result confirmed 3.2-cm grade 3 invasive intracystic papillary carcinoma with negative sentinel lymph node biopsy.
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Radiological Society of North America
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