Invasive lobular carcinoma

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Clinical History:
Clinical history: 59 year old female presented for breast MRI after the ultrasound-guided core biopsy of a 10 x 11 mm mass in the 4 o’clock axis of the left breast showed invasive lobular carcinoma.

Diagnosis:
Invasive lobular carcinoma.

MR Technique:
3T MR (Siemens Verio), Images 1 and 2: Dynamic axial 3-D T1 images with fat saturation after injection of 0.1 mmol/kg of gadolinium chelate (TR/TE 5/2 ms, FA 10, slice thickness 1mm, scan time: 1min 11 sec. Image 3: Time enhancement curves were generated utilizing DynaCAD (Invivo) software.

Imaging Findings:
The 1 x 1.1 cm ill-defined mass in the 4 o’clock axis of the left breast, posterior depth, demonstrates an internal signal void compatible with the biopsy clip. This lesion is compatible with the biopsy proven malignancy. The time enhancement curve shows rapid initial uptake followed by delayed washout post initial enhancement which is a kinetic curve most concerning for malignancy. An additional irregularly shaped, enhancing, 0.8 cm mass is noted along the 9 o’clock axis of the left breast, 3.8 cm from the nipple. There is also a 1.1 cm heterogeneously enhancing mass in the subareolar region of the right breast.