Apport de l’IRM dans le diagnostic et le bilan d’extension des cancers lobulaires infiltrants

Abstract

Purpose To assess the use of breast MRI for the diagnosis and staging of invasive lobular carcinoma and its impact on surgical management. Materials and methods Retrospective study of 35 invasive lobular carcinoma, histologically diagnosed in 34 patients who underwent clinical exam, mammography, ultrasonography and magnetic resonance imaging. Results Enhancement at MRI was seen for all 35 cancers. It was focal for 24 patients, regional for10 and diffuse for 1. The kinetic of the enhancement was characteristic of malignancy for 33 patients. For 11 patients the MRI staging was positive, finding 8 news cancers. For 3 patients MRI lead to biopsy of benign lesions but improved the surgical management in the 8 cases of new cancers: wider excision for 3 cases, planned breast conservation converted to mastectomy in 3 cases and excision of contralateral lesion in 2 cases. Conclusion Breast MRI is useful in diagnosis, staging and surgical management of invasive lobular breast carcinoma.