First AD

Second AD

 positive patient presented for a bilateral screening breast MRI. On MRI, two irregular enhancing masses were detected in the right breast, measuring 12 mm and 4 mm (Figure 1).

Targeted ultrasound was performed and demonstrated two ill-defined, hypoechoic masses in the 3 o’clock area corresponding to the MRI findings (Figures 2, 3). An ultrasound guided needle core biopsy of the larger mass was performed.


Core needle biopsy of the larger right breast mass was performed under ultrasound guidance revealing invasive ductal carcinoma. At surgical excision there were two foci of cancer in the right breast.

 gene mutation have an increased risk of developing breast cancer. The American Cancer Society (ACS), Society of Breast Imaging (SBI), and American College of Radiology (ACR) recommend breast MRI screening for 

positive patients, as well as an annual mammography. Although mammography is the gold standard for detecting breast cancer, the sensitivity of MRI has shown to be greater than that of mammography. Studies have demonstrated that the increased sensitivity is due to the ability of MRI to detect very small cancerous lesions that are more difficult to distinguish on mammography.

1. Warner E, Hill K, Causer P, et al. Prospective Study of Breast Cancer Incidence in Women With a BRCA1 or BRCA2 Mutation Under Surveillance With and Without Magnetic Resonance Imaging. 

2. Passaperuma K, Warner E, Causer PA, et al. Long-term results of screening with magnetic resonance imaging in women with BRCA mutations. 

Image IQ

Mammography

53-year-old BRCA2 positive patient presented for bilateral screening breast MRI.

Image IQ: 53-year-old, BRCA2 Positive, Screening Mammo

Stamatia Destounis, MD, FACR