MRI and triple receptor-negative breast carcinomas

In our article we aimed to identify the imaging characteristics of triple receptor–negative (TRN) breast cancers—on mammography, sonography, and MRI—and to determine whether MRI has a role in confirming equivocal clinical or conventional imaging (mammography and ultrasound) findings. We found that despite their large size at clinical presentation, TRN cancers were frequently occult or benign-appearing on conventional imaging. On MRI, TRN breast carcinomas showed rim enhancement, central contrast-enhanced septations, necrosis and washout kinetics, all of which have a high positive predictive value for malignancy. 11% of the 23% multicentric foci were exclusively identified by MRI in our series. The clinical implications of these findings are twofold: first, MRI provides a reliable baseline characterization of these cancers to facilitate monitoring of response to neoadjuvant chemotherapy. Second, MRI  may have a role in the detection of additional triple receptor–negative cancers in the ipsilateral breast that are not easily identified with mammography or ultrasound, as well as screening the contralateral breast for synchronous occult malignancy

Bibliographic Reference:

Dogan BE et al.: "Multimodality imaging of triple receptor-negative tumors with mammography, ultrasound, and MRI", AJR Am J Roentgenol. 2010: 194(4):1160-6.

Basak E. Dogan

Departments of Radiology and Breast Imaging-Unit, The University of Texas M. D. Anderson Cancer Center , Houston, TX, USA