A 41 year old female patient presented with a new palpable mass in the left upper lateral quadrant. In regards to the patient’s family history, her mother developed breast cancer at 40 years of age, her sister at 38 years of age and her aunt at 30 years of age. On the mammogram, extensive dense breast parenchyma was noted on both sides, corresponding to an ACR4 classification, and thus a limited evaluation. On the basis of this exam alone, no tumor or architectural disorder could be detected. Due to the patient’s family history additional MR-Mammography was performed for further evaluation.
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A 69 year old female patient with hemorrhagic nipple discharge on the left side. Clinical assessment revealed no palpable mass, and no signs of inflammation. Mammography and ultrasound were within normal limits.
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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.
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A 44-year-old female presented with an abnormal right breast imaging by routine screening mammography. She then obtained a breast ultrasound, which showed a solid mass in the right breast measuring. A core needle biopsy was performed revealing intraductal adenocarcinoma. An MRI was the obtained to evaluate the extent of the disease.
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With breast carcinoma, detection of metastases and estimation of tumor load is of high relevance for patient-individualized therapy regimes. This article presents two cases that show the advantages of MRI for imaging bone metastases originating from breast cancer. In both cases, there was the high clinical suspicion of tumor recurrence with metastastic spread. The patients underwent therefore combined whole- body 18F FDG PET/CT and whole-body MRI for tumor staging with special focus on the brain, liver and bone marrow.
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