European Journal of Radiology

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European Journal of Radiology Repeated surgeries in invasive lobular breast cancer with preoperative MRI: Role of additional carcinoma in situ and background parenchymal enhancement H. Preibsch, V. Richter, S.D. Bahrs, V. Hattermann, B.M. Wietek, G. Bier, C. Kloth, G. Blumenstock, M. Hahn, A. Staebler, K. Nikolaou, B. Wiesinger European Journal of Radiology Volume 90, Pages 181-187 (May 2017) DOI: 10.1016/j.ejrad.2017.02.045 Copyright © 2017 Elsevier B.V. Terms and Conditions

Fig. 1 Number of cases with breast conserving therapy (BCT) and mastectomy in all patients (ILC±CIS), patients with ILC but without CIS (ILC-CIS) and with additional CIS (ILC+CIS). European Journal of Radiology 2017 90, 181-187DOI: (10.1016/j.ejrad.2017.02.045) Copyright © 2017 Elsevier B.V. Terms and Conditions

Fig. 2 43 year-old female with US-detected BI-RADS® 4 lesion in the upper outer quadrant of the right breast. On MG (2a–d) there is a presumably corresponding oval densification (*) on the CC-view, which is not detectable in both views (BI-RADS® category 3). The sonographic BI-RADS® 4 lesion was biopsied US-guided and proved to be ILC. On the maximum intensity projection (MIP) of the preoperative MRI (2e) a corresponding, but smaller suspicious lesion (arrow) and another BI-RADS® 4 lesion in the centre of the breast (arrowhead), which was biopsied through MRI-guidance and was another focus of carcinoma. Histopathology revealed bifocal ILC (14mm and 2mm) without additional CIS. European Journal of Radiology 2017 90, 181-187DOI: (10.1016/j.ejrad.2017.02.045) Copyright © 2017 Elsevier B.V. Terms and Conditions

Fig. 3 62 year-old female with a mass suspicious for lymph node metastasis in the upper outer quadrant of the right breast (arrow) and an architectural distortion in the centre of the breast (*), Fig. 3a–d. No suspicious calcifications. On the subtraction images of the MRI (3e) broad area of suspicious non-mass enhancement in the right breast. MRI induced a change of the surgical procedure (mastectomy). Histopathology revealed unifocal cT3 N+ breast cancer with a 70mm lobular CIS. No repeated surgery was performed. European Journal of Radiology 2017 90, 181-187DOI: (10.1016/j.ejrad.2017.02.045) Copyright © 2017 Elsevier B.V. Terms and Conditions