How are benign and malignant disease differentiated on postsurgical breast MRI?

Updated: Dec 19, 2018
  • Author: Susan Ackerman, MD; Chief Editor: Eugene C Lin, MD  more...
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On MRI, fat necrosis (FN) has different presentations depending on the stage of the process. The most common MRI image is a round or oval mass showing high signal intensity on T1-weighted non-fat-saturated images; the mass appears hyperintense on T2-weighted non-fat-saturated images and hypointense on fat-saturated images. T1-weighted fat-suppressed sequences are helpful to differentiate fat from blood, which also shows high-signal intensity on T1-weighted images. Because fat-containing lesions are extremely uncommon in malignant conditions, the presence of fat is extremely useful in differentiating FN from a malignant lesion. [14]  

Overlap exists between benign and malignant disease. Suspicious findings may warrant tissue sampling. A false-positive diagnosis may be made if enhancement is seen.

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