Role of breast magnetic resonance imaging in determining breast as a source of unknown metastatic lymphadenopathy

Am J Surg. 1999 Dec;178(6):496-500. doi: 10.1016/s0002-9610(99)00221-4.


Background: Occult primary breast cancer (OPBC) represents less than 1% of breast cancer. In only a third of cases, mammography identifies a primary tumor. We hypothesized that rotating delivery of excitation off-resonance breast magnetic resonance imaging (MRI) would identify or exclude the breast as a primary site in patients with OPBC.

Methods: In a retrospective review, 10 patients were identified with OPBC in which MRI was performed. Malignant appearing lesions were correlated with histopathologic findings at biopsy or surgery.

Results: MRI identified the primary site in 8 of 10 cases as breast (80%), and excluded it in 2 cases. The extent of disease and location was accurately predicted when compared with histopathologic specimen.

Conclusions: As we continue to focus on a cure of early breast cancer, it is imperative that diagnostic images become more sensitive and specific. MRI accurately predicted OPBC in this subset of patients.

MeSH terms

  • Adult
  • Aged
  • Breast / pathology*
  • Breast Neoplasms / pathology*
  • Female
  • Humans
  • Lymphatic Metastasis
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Neoplasms, Unknown Primary* / pathology
  • Retrospective Studies
  • Sensitivity and Specificity