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Purpose: Analyze neoadjuvant chemotherapy (NAC) effect on breast MR (BPE). Determine association between BPE changes and tumor response. Methods and materials: IRB-approved, analytic retrospective study. All and had pre-treatment and followup 3T MARI studies between December BPE was analyzed on subtraction images and axial and sagittal MIP. Tumors were classified according to histology as invasive ductal carcinoma and grouped by immunohistochemical (IHC) subtype: Luminal A, Lumina Triple negative (TN). Imaging response was evaluated using RECIST 1.1 Results: 40 patients were included, mean age of 47 + 9.9 years, 67,5 % were premenopausal. Histopathological analysis revealed 37 cases of IDC, two ILC and one IDC+ILC. IHC assessment showed 12 TN,10 Luminal A, 10 Luminal B and 8 (HL). There was a global reduction of BPE after NAC in women (Pv= 0.01). TN and HL had higher initial BPE, and postmenopausal women (Pv= 0.001). TN and HL had higher initial BPE, and postmenopausal patients had an OR of 6.4 for having a mild BPE prior to NAC. 32,5% of patients had complete imaging response. Ap A/B 1HC subtype were associated with higher OR for partial tumor response (OR 1.8,2 y 5.7, respectively), although only IHC subtype reached statistical significance. Conclusion: Decrease in BPE signal after NAC may be used as a predictive factor of tumor response. [ABSTRACT FROM AUTHOR]

Purpose: Hyperechogenic breast lesions have been described as pa 0d benign and are rarely biopsied. The aim of this work was to evaluate the frequency of malignant hyperechogenic breast lesions, describe their imaging findings and histopathological characteristics. Methods and materials: IRB approved, retrospective, descriptive case series. Biopsied hyperechogenic lesions were selected from a database of 3.394 consecutive USguided breast Core biopsies (1,020 malignant, 299 high-risk and 2,075 benign lesions) performed between 2006 and 2016. Any lesion that presented greater echogenicity than subcutaneous cellular tissue of more than 90% of its volume, was considered hyperechogenic. Demographical data, US and histopathological characteristics were recorded. Results: In total 27 (1,08%) lesions biopsied were hyperechogenic: 21 (57%) of them had benign results. Sixteen patients (mean age: 52 years; range: 26-80) had hyperechogenic cancer, representing 1,5% (16/1,020) of all malignancies: 1 CDIS and 15 invasive carcinomas (81% ductal and 19% lobular histology). Mean size = 2 cm, range: 7- 30 mm. All of them exhibited a small central hypoechoic foci and were partially or completely surrounded by fatty tissue. Shape, margins, orientation and vascular architecture were highly suggestive of malignancy on US, mammogram and MARI (features BI-RADS 4 and 5). In histopathological exam these cancer$ were surrounded by adipose tissue (not by fibroglandular tissue); also, they presented a hypocellular collagenous center and were hypercellular on ¡ts periphery, intermixing with fatty tissue, fibrous tracts and collagen. Conclusion: Hyperechogenic cancers are very rare (less than 2% of breast cancers), but it is important to recognize them to avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the usefulness of preoperative MAI study in patients with pure ductal carcinoma in situ (DCIS). Methods and materials: IRB approved, retrospective, descriptive observational study, of a series of cases. Patients with breast cancer operated between January 2015 and March 2017 were reviewed and pure DCISs with mammography (Mx), ultrasound (US), and preoperative MRI available in PACS were selected. Bland-Altman test was used to describe the size concordance considering the histopathology of the surgical specimen as the reference standard. The MAI contribution was classified into 4 groups. Group 1: MARI provided the same information as conventional studies. Group 2: improved the description of tumor size without changing surgical approach. Group 3: generated unnecessary procedures. Group 4: correctly changed the surgical management. Results: Of 467 cancers operated, 77 (16.5%) were DCIS, 41 (53.2%) pure and 36 with microinvasion (46.8%). Thirtythree patients met inclusion criteria. Average age 52.78 + 12.55 years. The detectability of the lesions was 90.9%, 30.3% and 74.2% for the Mx, US and MARI respectively. Concordance index of tumor size: MRI=73.3%, US=70% and Mx=58.1%. MRI contribution in preoperative staging: Group 1=18 cases (58%), Group 2= 3 cases (9.7%), Group 3=0 and Group 4=2 cases (6,5%). Conclusion: Undoubtedly Mx is the main method of detection of pure DCIS. However, MAI proved to be the best technique to evaluate tumor size, allowing better preoperative staging than conventional studies in 15% of cases, even to correctly change surgical management in 6%. [ABSTRACT FROM AUTHOR]