Investig Magn Reson Imaging.  2015 Sep;19(3):137-145. 10.13104/imri.2015.19.3.137.

Invasive Lobular Carcinoma: MRI Features and Clinicohistological Characteristics According to the ER, PR, and HER2 Statuses

• Yoo EY
• Nam SY
• Choi HY
• Cho HY

• KMID: 2175604
• DOI: http://doi.org/10.13104/imri.2015.19.3.137

Abstract

PURPOSE
To investigate correlations of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor type 2 (HER2) statuses with magnetic resonance imaging (MRI) features and clinicohistological characteristics in patients with invasive lobular carcinoma (ILC).
MATERIALS AND METHODS
Data from 64 histologically confirmed ILCs were analyzed retrospectively. Preoperative breast MRI was reviewed for morphology and dynamic contrast-enhanced kinetics of the tumor. Pathologic reports were reviewed for ER, PR, and HER2 positivity, tumor size, lymph node metastasis, and the number of metastatic lymph nodes. Furthermore, there was an investigation of the MRI features and clinicohistologic characteristics, according to the ER, PR, and HER2 statuses.
RESULTS
A significant difference in MRI features and clinicohistological tumor characteristics were observed only in relation to PR status. Of the 64 ILCs, 10 (15.6%) were PR negative. PR negative cancers, compared with PR positive cancers, were more likely to present as non-mass enhancement (P = 0.027); have a significantly larger mean tumor size (5.00 +/- 1.05 cm vs. 2.57 +/- 0.21 cm, P = 0.021); and have significantly more metastatic lymph nodes (P = 0.010).
CONCLUSIONS
PR negative ILC presented more frequently as non-mass enhancement on MRI, with larger tumors and increased numbers of metastatic lymph nodes. Therefore, the PR status plays an important role in determining MRI features and clinicohistological characteristics of ILC.

Keyword

Invasive lobular carcinoma; Receptor status; Breast magnetic resonance imaging

MeSH Terms

Breast
Carcinoma, Lobular*
Estrogens
Humans
Kinetics
Lymph Nodes
Magnetic Resonance Imaging*
Neoplasm Metastasis
Receptor, Epidermal Growth Factor
Receptors, Progesterone
Retrospective Studies
Estrogens
Receptor, Epidermal Growth Factor
Receptors, Progesterone

Figure

• 

  Fig. 1 A 40-year-old woman with PR positive ILC. (a) Axial T2-weighted image with fat suppression shows a hyperintense lesion in the right breast (arrow). (b) Axial contrast-enhanced MR image in early dynamic phase shows a heterogeneously enhanced irregular mass (arrow). (c) Kinetic curve of dynamic MRI shows initial fast and delayed washout enhancement pattern.

• 

  Fig. 2 A 43-year-old woman with PR negative ILC. (a) Axial T2-weighted image shows a slightly hyperintense lesion in the right breast (arrow). (b) Axial contrast-enhanced MR image in early dynamic phase shows segmental heterogeneous internal enhancement pattern of non-mass enhancement (arrow). (c) The MIP image also demonstrates a non-mass enhancement lesion (arrows).

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