EFFECT OF NEOADJUVANT CHEMOTHERAPY (NAC) ON MR IMAGING APPEARANCE OF A BENIGN BREAST LESION: A CASE REPORT

Berrin Erok

EFFECT OF NEOADJUVANT CHEMOTHERAPY (NAC) ON MR IMAGING APPEARANCE OF A BENIGN BREAST LESION: A CASE REPORT

Berrin Erok

Abstract

Background

In patients with newly diagnosed breast cancer, additional breast lesions with probably benign morphology may cause a difficulty in diagnosis when they respone to neoadjuvant chemotheraphy. We report a case of contrlateral breast lesion with probably benign morphology,which showed total loss of contrast enhancement after NAC.

Case report

A 41-year-old female patient presented with a palpable left breast mass.Ultrasonography demonstrated 35x25 mm heterogenous hypoechoic mass with indistinct margins,On the right breast, there was a 7x4 mm hypoechoic lesion which was considered as BI-RADS 3 lesion.On breast MR imaging the left breast lesion showed rapid heterogenous enhancement which was considered to be a BI-RADS 5 lesion.The right breast lesion showed progressive contrast enhancement. Tru-cut needle biopsy of the BI-RADS 5 lesion and left axillary LAP revealed out not otherwise specified invasive ductal carcinoma (NOS-IDC) with axillary metastasis. NAC was planned before surgical management. At 6 th month, follow up MRI reveaed out total regression of the left breast BI-RADS 5 lesion with no contrast enhancement.The right sided lesion also showed no contrast enhancement.Although on targeted US this right breast mass was seen as similar with its pre NAC appearance excision of the mass was decided with the malignant lesion at the same operation. Histopathological result of the right breast mass was reported as fibroadenom.

Coclusion

Additional ipsilateral or contralateral breast lesions with otherwise probabbly benign appearance seen on preoperative MRI that respond to NAC in the similar way with the malignant lesion on follow up MR imaging may not be a malignant focus.

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