PURPOSE: This study was undertaken to investigate X-ray mammographic findings which correlated with histopathologic classification of breast carcinomas. MATERIALS AND METHODS: In 114 cases (113 patients) weeviewed X-ray mammographic findings of breast carcinoma and their histopathologic classification, and the findings were analysed to define mass, calcification, and spiculation. RESULTS: According to histopathologic classifications of breast carcinomas, infiltrating ductal carcinoma was the most common(78.9%). X-rays mammographyrevealed that irregular mass was found in 43.9% of cases, calcification in 47.4 %, and radiating spiculation in75.4%. Mass with spiculation accounted for 41.2%, and mass with calcification and spiculation for 34.2%. A commonfinding of ductal carcinoma in situ was an ill-defined mass with malignant clustered microcalcification. Infiltrating ductal and infiltrating lobular carcinomas showed irregular masses with spiculation and colloid or medullary carcinomas had well-defined masses. CONCLUSION: Mass with spiculation, and mass with calcification and spiculation were common findings of breast carcinoma. The differences in X-ray mammographic findings among each different histopathologic type of breast carcinoma are helpful for differential diagnosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Classification* ; Colloids ; Diagnosis, Differential

PURPOSE: The relationship between menopausal status at diagnosis and the prognosis in breast carcinoma remains uncertain. However, it is widely considered that breast cancer in young women is more lethal than in older patients. We therefore attempted to determine whether menopausal status could be a useful prognostic factor for breast cancer. METHODS: A retrospective study was conducted of premenopausal women who had undergone a definite operation between Jan. 1997 and Dec. 1998 in the Department of Surgery, Samsung Medical Center. Clinical features, histopathologic findings, and prognostic factors were evaluated and compared with those for the equivalent surgical group of postmenopausal women. RESULTS: There were 207 cases (86.3%) of infiltrating ductal carcinomas, 10 (4.2%) of infiltrating lobular carcinomas, 6 (2.5%) of ductal carcinomas in situ, and 16 (6.7%) of special type cancers which showed good prognosis. There were some differences in these incidences from those of the postmenopausal women, but they were not statistically significant (P>0.05). Tumor size and lymph nodal status showed no difference between the two groups (P=0.288), nor were there any significant differences in terms of TNM stage, ER/PR status, nuclear or histologic grade (P>0.05). CONCLUSION: There were little differences in pathologic and prognostic factors between premenopausal and postme no-pausal breast cancer patients. Premenopausal status and young age did not have poorer prognostic factors and were predicted to have not worse prognosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Incidence ; Prognosis ; Retrospective Studies

PURPOSE: The relationship between menopausal status at diagnosis and the prognosis in breast carcinoma remains uncertain. However, it is widely considered that breast cancer in young women is more lethal than in older patients. We therefore attempted to determine whether menopausal status could be a useful prognostic factor for breast cancer. METHODS: A retrospective study was conducted of premenopausal women who had undergone a definite operation between Jan. 1997 and Dec. 1998 in the Department of Surgery, Samsung Medical Center. Clinical features, histopathologic findings, and prognostic factors were evaluated and compared with those for the equivalent surgical group of postmenopausal women. RESULTS: There were 207 cases (86.3%) of infiltrating ductal carcinomas, 10 (4.2%) of infiltrating lobular carcinomas, 6 (2.5%) of ductal carcinomas in situ, and 16 (6.7%) of special type cancers which showed good prognosis. There were some differences in these incidences from those of the postmenopausal women, but they were not statistically significant (P>0.05). Tumor size and lymph nodal status showed no difference between the two groups (P=0.288), nor were there any significant differences in terms of TNM stage, ER/PR status, nuclear or histologic grade (P>0.05). CONCLUSION: There were little differences in pathologic and prognostic factors between premenopausal and postme no- pausal breast cancer patients. Premenopausal status and young age did not have poorer prognostic factors and were predicted to have not worse prognosis.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Incidence ; Prognosis ; Retrospective Studies

PURPOSE: Infiltrating lobular carcinoma (ILC) represents approximately 10% of all breast cancers. Its detection and staging for appropriate surgical planning may be difficult on account of its unique growth pattern, including a linear file arrangement of the tumor cells and a planar growth pattern and the resulting low density of the lesions. The purpose of this study was to evaluate the clinicopathological features of an ILC of the breast including multifocality, the preoperative accuracy of the pathological diagnostic tools, and its impact on the surgical procedure. METHODS: Between 1997 and 2003 at the Asan Medical Center, a group of 63 patients with a pathologically proven invasive lobular carcinoma who had undergone surgery were included. They were all in stage I~III, and their medical records, mammographic and sonographic results, and pathologic findings were reviewed retrospectively. RESULTS: Of the 63 patients with a mean age of 48 years (range 35 to 70), multifocal lesions were identified in 27.0% by a pathological examination. For a preoperative evaluation of a multifocal lesion, the sensitivity and positive prediction value were 21.4% and 50% by mammography, and 92.9% and 52.0% by ultrasonography, respectively. Only 27.0% of all patients were confirmed as having an ILC preoperatively; surgical excision or incision biopsies 75%, core-needle biopsy 36.4%, frozen biopsy 22.7%, FNA 5.9%. Conservative surgery was performed in only 14.3% and a mastectomy was performed on 85.5%. The mean tumor size was 3.0 cm, and according to the TNM stage, stage I was found in 22.2%, stage II in 58.7%, stage III in 19.1%. ER-positive was found in 83.9% and PR-positive was found in 74.2%. Seven out of 11 patients, who underwent the planed conserving surgery, had a positive resection margin, 1 case had re- excision, 2 cases underwent mastectomies, and 4 cases underwent radiation therapy without additional surgery. CONCLUSION: Since invasive lobular carcinomas have more often multifocal lesions and a preoperative accurate evaluation may be difficult pathologically or radiologically, a careful evaluation of the accurate tumor extent as well as the multifocal lesion is needed particularly for patients with an ILC considering conserving surgery.
Biopsy ; Breast* ; Carcinoma, Lobular* ; Chungcheongnam-do ; Diagnosis* ; Humans ; Mammography ; Mastectomy ; Medical Records ; Retrospective Studies ; Ultrasonography

PURPOSE: To review MR imaging finding of papillary lesion identified as additional suspicious lesion on MR image in women with biopsy-proven breast cancer and to evaluate upgrading rates after subsequent surgical histopathological diagnosis. MATERIALS AND METHODS: Among 1729 preoperative MR image of women with biopsy proven breast cancer, US-guided CNB-proven 22 papillary lesions from 21 patients, which showed additional suspicious contrast enhancement other than index cancer on MR image, were subjected to the study. Some of these lesions underwent surgery, thus the comparisons between the histopathologic results were able to be compared to the results of US guided CNB. Also retrospective analysis was done for MR findings of these lesions by BI-RADS MRI lexicon. RESULTS: On MR imaging, 8 mass lesions, 7 non-mass lesions, 7 focus lesions were detected. All of the focus lesion (100%, 7/7) was diagnosed as benign lesion and showed plateau and washout pattern in dynamic MR image. After excisional biopsy, one of 9 benign papilloma (11.1%), 3 of 3 papillary neoplasm with atypia component (100%), 3 of 5 papillary neoplasm (60%) were upgraded to malignancy such as ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC). CONCLUSION: The MR images of papillary lesions diagnosed by US-guided CNB exhibit no significant differences between malignancy and benign lesion. Also 41.2% of the lesion (7/17) was upgraded after subsequent surgery. Thus all of the papillary lesions require excisional biopsy for definite diagnosis and the MR imaging, it's just not enough by itself.
Biopsy ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Papilloma ; Retrospective Studies

Breast/pathology* ; Breast Neoplasms/pathology* ; Carcinoma in Situ/pathology* ; Carcinoma, Lobular/pathology* ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia/pathology*

The incidence of synchronous bilateral infiltrating breast cancer has been reported to be 2%. However, synchronous unilateral infiltrating ductal carcinoma and infiltrating lobular carcinoma (ILC) are very rarely reported. We present a woman with palpable ILC who was later found to have synchronous well-circumscribed ductal carcinoma on further imaging. We also discuss the use of diagnostic approaches such as ultrasonography, mammography and histopathology. This case highlights the importance of careful assessment of concurrent lesions in the breast in the presence of an existing carcinoma.
Breast Neoplasms ; complications ; diagnosis ; Carcinoma, Ductal, Breast ; complications ; diagnosis ; Carcinoma, Lobular ; complications ; diagnosis ; Female ; Humans ; Mammography ; Middle Aged ; Neoplasms, Second Primary ; diagnosis

Krukenberg tumor of the primary breast carcinoma is rare and this is almost invasive lobular carcinoma. They are usually bilateral and frequent in premenopausal women. Diagnosis of symptomatic Krukenberg tumor is reported to be 1 or 2 year after the diagnosis of primary neoplasm. But sometimes it is discovered prior to the detection of the primary breast carcinoma. Unexpected ovarian micrometastasis was recognized after oophorectomy of normally appearing ovaries in breast cancer patients. Existence of Krukenberg tumor means advanced primary disease and possible metastasis to other organs, and have a poorer prognosis. We report a case of Krukenberg tumors occurred 3 years after the diagnosis of primary ductal type breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Diagnosis ; Female ; Humans ; Krukenberg Tumor* ; Neoplasm Metastasis* ; Neoplasm Micrometastasis ; Ovariectomy ; Ovary* ; Prognosis

PURPOSE: To evaluate the contrast-enhanced MR findings of lesions associated with a radial scar and to compare the MR findings with the histopathology results. MATERIALS AND METHODS: From Mar. 2001 to Sep. 2005, 8 patients with a surgically proven radial scar who had undergone MRI, mammography, and ultrasonography were enrolled in this study. The morphological findings and dynamic enhancement pattern of the time-intensity curve were retrospectively reviewed using non-contrast and contrast-enhanced MRI. Mammography and ultrasonography were also analyzed according to the BI-RADS category and correlated with the histopathological diagnosis. RESULTS: The age of the patients ranged from 42 to 53 years (mean, 47 years). Five patients presented with a left breast lesion and the others presented with a right breast lesion. The histopathological diagnosis associated with the radial scar were fibrocystic changes (n=1), adenosis (n=2), atypical ductal hyperplasia (n=2), lobular carcinoma in situ (n=1), ductal carcinoma in situ (n=1), and invasive ductal carcinoma (n=1). In all patients, architectural distortion without microcalcification was observed with mammography. Irregular shaped hypoechoic lesions with an indistinct, spiculated, or angular margin was observed in all patients with ultrasonography. Posterior shadowing was observed in 4cases. MR enhancement revealed two cases with foci enhancement (adenosis and fibrocystic change), five cases with non-mass-like focal enhancement (fibrocystic change, atypical ductal hyperplasia, lobular carcinoma in situ, ductal carcinoma in situ, invasive ductal carcinoma), and one irregular homogeneous mass enhancement (atypical ducal hyperplasia). The time-signal intensity curves are as follows: persistent type (n=2), adenosis, and fibrocystic changes, respectively; plateu type (n=4), one adenosis, two atypical ductal hyperplasia, and one ductal carcinoma in situ; and washout type (n=2), lobular carcinoma in situ, and invasive ductal carcinoma, respectively. CONCLUSION: Although a combined benign or malignant pathology with a radial scar was not predicted on the preexisting image modality, contrast-enhanced MRI can help to predict a combined benign or malignant pathology with a radial scar using the morphological findings and the dynamic enhancement type of the time-intensity curve.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Cicatrix* ; Diagnosis ; Humans ; Hyperplasia ; Magnetic Resonance Imaging ; Mammography ; Pathology ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography

PURPOSE: To evaluate the contrast-enhanced MR findings of lesions associated with a radial scar and to compare the MR findings with the histopathology results. MATERIALS AND METHODS: From Mar. 2001 to Sep. 2005, 8 patients with a surgically proven radial scar who had undergone MRI, mammography, and ultrasonography were enrolled in this study. The morphological findings and dynamic enhancement pattern of the time-intensity curve were retrospectively reviewed using non-contrast and contrast-enhanced MRI. Mammography and ultrasonography were also analyzed according to the BI-RADS category and correlated with the histopathological diagnosis. RESULTS: The age of the patients ranged from 42 to 53 years (mean, 47 years). Five patients presented with a left breast lesion and the others presented with a right breast lesion. The histopathological diagnosis associated with the radial scar were fibrocystic changes (n=1), adenosis (n=2), atypical ductal hyperplasia (n=2), lobular carcinoma in situ (n=1), ductal carcinoma in situ (n=1), and invasive ductal carcinoma (n=1). In all patients, architectural distortion without microcalcification was observed with mammography. Irregular shaped hypoechoic lesions with an indistinct, spiculated, or angular margin was observed in all patients with ultrasonography. Posterior shadowing was observed in 4cases. MR enhancement revealed two cases with foci enhancement (adenosis and fibrocystic change), five cases with non-mass-like focal enhancement (fibrocystic change, atypical ductal hyperplasia, lobular carcinoma in situ, ductal carcinoma in situ, invasive ductal carcinoma), and one irregular homogeneous mass enhancement (atypical ducal hyperplasia). The time-signal intensity curves are as follows: persistent type (n=2), adenosis, and fibrocystic changes, respectively; plateu type (n=4), one adenosis, two atypical ductal hyperplasia, and one ductal carcinoma in situ; and washout type (n=2), lobular carcinoma in situ, and invasive ductal carcinoma, respectively. CONCLUSION: Although a combined benign or malignant pathology with a radial scar was not predicted on the preexisting image modality, contrast-enhanced MRI can help to predict a combined benign or malignant pathology with a radial scar using the morphological findings and the dynamic enhancement type of the time-intensity curve.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Carcinoma, Lobular ; Cicatrix* ; Diagnosis ; Humans ; Hyperplasia ; Magnetic Resonance Imaging ; Mammography ; Pathology ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography