Dr Naglaa is an active member in the Women’s Health Outreach Program at the Ministry of Health and she is serving in the project as the Radiologists Quality Manager. She is an active member and Board member of many National & International societies, She is the Assistant Secretary General of the Egyptian Society of Women Imaging and Health care & she is an international Board member of the American Association of Women Radiologists. Dr Naglaa has many national and international publications and has presented many presentations in national and international conferences especially concerned with breast cancer. Dr. Naglaa’s favorite mission is to fight breast cancer.
Background: The clinical detection of ILC can also be difficult, since ILC frequently fails to form a palpable lesion. This tendency of ILC to have atypical imaging and clinical appearances is related to its histopathologic features and its failure to elicit a desmoplastic response. Aim of the study: It is a retrospective study aiming to provide diagnostic characterization of ILC in Dynamic MR-Mammography and to compare its diagnostic performance to mammography and ultra sonography. Material & Method: A total of 56 cases of ILC were selected in retrospective review of the mammography, ultrasonography & Dynamic MRM of 420 patients with invasive breast cancer who were seen from January 1, 2007, through October 31, 2010. The pathology of all cases was available for review. Results: Asymmetric density was the commonest mammographic finding and the measured sensitivity of mammography in detecting ILC is 87.5% (9/56 FN). The most common US manifestation of ILC is a focal shadowing without a discrete mass and its measured sensitivity is 84.9% (10/56 FN). At MR imaging, the most common manifestation of ILC was a solitary irregular or angular mass with speculated or ill-defined margins (33.9% of cases [n=19]). The measured sensitivity is 96.5% (2/56 FN). Additional data which affected the patient management including the presence of multifocal or multi centric disease, chest wall involvement and contralateral breast cancer were encountered in (48.2% of cases [n=27]). Unlike most invasive breast carcinomas, which demonstrate a classic pattern of rapid enhancement and washout, ILC has a tendency to demonstrate delayed maximum enhancement, with washout exhibited by only a minority of lesions (21.4% [n = 12]). Conclusion: MR imaging has proved to be a useful superior to mammography and US in the detection and management of ILC. It provides useful information for further management and pre-surgical planning.