Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case report

An 80-year-old woman with a left breast mass was referred to our department. Mammography showed an oval mass, 2.5cm in size, with circumscribed margins in her left breast. Ultrasound showed an oval tumor with circumscribed margins, heterogenous internal echoes including numerous punctate hyperechoic...

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Main Authors: Senri Kondo, Shoji Oura, Mariko Honda
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325002006
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author Senri Kondo
Shoji Oura
Mariko Honda
author_facet Senri Kondo
Shoji Oura
Mariko Honda
author_sort Senri Kondo
collection DOAJ
description An 80-year-old woman with a left breast mass was referred to our department. Mammography showed an oval mass, 2.5cm in size, with circumscribed margins in her left breast. Ultrasound showed an oval tumor with circumscribed margins, heterogenous internal echoes including numerous punctate hyperechoic foci, and posterior echo enhancement. Magnetic resonance imaging (MRI) of the tumor showed low and high signal intensity on T1-weighted images and on fat-suppressed T2-weighted images, respectively. Kinetic curve assessment of the tumor showed a fast and plateau pattern. After the pathological confirmation of malignant cells, the patient underwent mastectomy and sentinel node biopsy. Postoperative pathological study showed that atypical cells formed irregularly arranged papillary nests and grew in a medullary fashion accompanied by massive lymphocyte infiltration, leading to the diagnosis of invasive ductal carcinoma with medullary features (IDCMF). Immunostaining showed that the tumor had a triple negative phenotype and a high Ki-67 labelling index of 52%. In conclusion, breast diagnostic physicians should note that IDCsMF show a fast and plateau enhancement pattern on MRI kinetic curve assessment. Furthermore, the presence of punctate hyperechoic foci in the tumor can be useful in distinguishing IDCsMF from medullary breast carcinomas.
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spelling doaj-art-3eb2cca79fcd41158525bcd18c1f65f62025-08-20T03:09:07ZengElsevierRadiology Case Reports1930-04332025-06-012062719272210.1016/j.radcr.2025.02.099Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case reportSenri Kondo0Shoji Oura1Mariko Honda2Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada-city, JapanDepartment of Surgery, Izumiotsu Municipal Hospital, Izumiotsu-city, Japan; Corresponding author.Department of Surgery, Izumiotsu Municipal Hospital, Izumiotsu-city, JapanAn 80-year-old woman with a left breast mass was referred to our department. Mammography showed an oval mass, 2.5cm in size, with circumscribed margins in her left breast. Ultrasound showed an oval tumor with circumscribed margins, heterogenous internal echoes including numerous punctate hyperechoic foci, and posterior echo enhancement. Magnetic resonance imaging (MRI) of the tumor showed low and high signal intensity on T1-weighted images and on fat-suppressed T2-weighted images, respectively. Kinetic curve assessment of the tumor showed a fast and plateau pattern. After the pathological confirmation of malignant cells, the patient underwent mastectomy and sentinel node biopsy. Postoperative pathological study showed that atypical cells formed irregularly arranged papillary nests and grew in a medullary fashion accompanied by massive lymphocyte infiltration, leading to the diagnosis of invasive ductal carcinoma with medullary features (IDCMF). Immunostaining showed that the tumor had a triple negative phenotype and a high Ki-67 labelling index of 52%. In conclusion, breast diagnostic physicians should note that IDCsMF show a fast and plateau enhancement pattern on MRI kinetic curve assessment. Furthermore, the presence of punctate hyperechoic foci in the tumor can be useful in distinguishing IDCsMF from medullary breast carcinomas.http://www.sciencedirect.com/science/article/pii/S1930043325002006Breast cancerFast and plateau patternMedullary featuresMRIPunctate hyperechoic foci
spellingShingle Senri Kondo
Shoji Oura
Mariko Honda
Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case report
Radiology Case Reports
Breast cancer
Fast and plateau pattern
Medullary features
MRI
Punctate hyperechoic foci
title Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case report
title_full Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case report
title_fullStr Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case report
title_full_unstemmed Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case report
title_short Breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images: A case report
title_sort breast cancer with medullary features shows a fast and plateau enhancement pattern on magnetic resonance images a case report
topic Breast cancer
Fast and plateau pattern
Medullary features
MRI
Punctate hyperechoic foci
url http://www.sciencedirect.com/science/article/pii/S1930043325002006
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AT shojioura breastcancerwithmedullaryfeaturesshowsafastandplateauenhancementpatternonmagneticresonanceimagesacasereport
AT marikohonda breastcancerwithmedullaryfeaturesshowsafastandplateauenhancementpatternonmagneticresonanceimagesacasereport