Which findings on magnetic resonance mammography (breast MRI) are characteristic of invasive ductal carcinoma (IDC)?

Updated: Feb 25, 2019
  • Author: Preeti Gupta, MD, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

On breast MRI, invasive ductal carcinoma (IDC) most often appears as an irregular, spiculated, or multilobulated mass with strong, rapid contrast enhancement that is at least 60% above baseline. Rim or inhomogeneous, centripetal enhancement on dynamic scans may be present. Typically, either a type II or type III enhancement curve is observed. Surrounding architectural distortion may be noted. About 5% of IDCs enhance slowly and/or less strongly, particularly if they are highly scirrhous. [32]

Surrounding enhancement of variable intensity may represent DCIS; florid dysplasia; or benign, parenchymal enhancement. Breast MRI may show multifocal lesions or nipple/chest-wall involvement, which may not be otherwise evident. Multifocal IDC may show moderate, segmental, ductal enhancement connecting the masses; such masses are thus seen to be part of the same breast segment, even if they are not close to one another. Internal, enhancing septa are sometimes seen in invasive carcinomas; these should be distinguished from nonenhancing septations, which are typical in fibroadenomas.


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