DOI: 10.1148/radiol.2251011029
Invasive Lobular Carcinoma of the Breast: Mammographic Characteristics and Computer-aided Detection1
W. Phil Evans, MD,
Linda J. Warren Burhenne, MD,
Louba Laurie, MD,
Kathryn F. O'Shaughnessy, PhD and
Ronald A. Castellino, MD
1 From the Susan G. Komen Breast Center, Baylor University Medical Center, Dallas, Tex (W.P.E., L.L.); the Department of Radiology, University of British Columbia, Vancouver, Canada (L.J.W.B.); and R2 Technology, Sunnyvale, Calif (K.F.O., R.A.C.). From the 2000 RSNA scientific assembly. Received June 13, 2001; revision requested August 6; final revision received March 15, 2002; accepted March 25. Address correspondence to W.P.E., UT Southwestern Center for Breast Care, 5323 Harry Hines Blvd, Dallas, TX 75390-8585 (e-mail: phil.evans@utsouthwestern.edu).
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Figure 1a. Current screening mammogram obtained in a 72-year-old woman. The radiopaque circle in the upper inner quadrant of the left breast is a skin marker. (a) Craniocaudal and (b) mediolateral oblique views of an asymmetric density (arrow) in the upper outer quadrant of the right breast. (c) Low-resolution digitized images of both breasts with CAD markers (*). The CAD system detects the spiculated mass (ILC) in both views. An additional mark (arrow) is present in the subareolar left breast in the mediolateral oblique view only. This area was classified by the interpreting radiologist as superimposed breast tissue. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) demonstrate a 1.5-cm irregular mass (arrows) with spiculation, best seen in the mediolateral oblique view.
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Figure 1b. Current screening mammogram obtained in a 72-year-old woman. The radiopaque circle in the upper inner quadrant of the left breast is a skin marker. (a) Craniocaudal and (b) mediolateral oblique views of an asymmetric density (arrow) in the upper outer quadrant of the right breast. (c) Low-resolution digitized images of both breasts with CAD markers (*). The CAD system detects the spiculated mass (ILC) in both views. An additional mark (arrow) is present in the subareolar left breast in the mediolateral oblique view only. This area was classified by the interpreting radiologist as superimposed breast tissue. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) demonstrate a 1.5-cm irregular mass (arrows) with spiculation, best seen in the mediolateral oblique view.
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Figure 1c. Current screening mammogram obtained in a 72-year-old woman. The radiopaque circle in the upper inner quadrant of the left breast is a skin marker. (a) Craniocaudal and (b) mediolateral oblique views of an asymmetric density (arrow) in the upper outer quadrant of the right breast. (c) Low-resolution digitized images of both breasts with CAD markers (*). The CAD system detects the spiculated mass (ILC) in both views. An additional mark (arrow) is present in the subareolar left breast in the mediolateral oblique view only. This area was classified by the interpreting radiologist as superimposed breast tissue. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) demonstrate a 1.5-cm irregular mass (arrows) with spiculation, best seen in the mediolateral oblique view.
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Figure 1d. Current screening mammogram obtained in a 72-year-old woman. The radiopaque circle in the upper inner quadrant of the left breast is a skin marker. (a) Craniocaudal and (b) mediolateral oblique views of an asymmetric density (arrow) in the upper outer quadrant of the right breast. (c) Low-resolution digitized images of both breasts with CAD markers (*). The CAD system detects the spiculated mass (ILC) in both views. An additional mark (arrow) is present in the subareolar left breast in the mediolateral oblique view only. This area was classified by the interpreting radiologist as superimposed breast tissue. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) demonstrate a 1.5-cm irregular mass (arrows) with spiculation, best seen in the mediolateral oblique view.
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Figure 2a. Current screening mammogram obtained in a 74-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show a subtle 1.5-cm area of architectural distortion and asymmetric density (arrow) in the posterior central portion of the left breast, seen best in a. (c) Low-resolution digitized images with CAD markers (*). Architectural distortion is identified in both views and was histologically related to ILC. An extra mark (arrow) is seen in the lateral left breast in the craniocaudal view only (left images). No major abnormality was found by the interpreting radiologist in this area. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) confirm parenchymal distortion (arrows) at the 12-o'clock position.
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Figure 2b. Current screening mammogram obtained in a 74-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show a subtle 1.5-cm area of architectural distortion and asymmetric density (arrow) in the posterior central portion of the left breast, seen best in a. (c) Low-resolution digitized images with CAD markers (*). Architectural distortion is identified in both views and was histologically related to ILC. An extra mark (arrow) is seen in the lateral left breast in the craniocaudal view only (left images). No major abnormality was found by the interpreting radiologist in this area. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) confirm parenchymal distortion (arrows) at the 12-o'clock position.
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Figure 2c. Current screening mammogram obtained in a 74-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show a subtle 1.5-cm area of architectural distortion and asymmetric density (arrow) in the posterior central portion of the left breast, seen best in a. (c) Low-resolution digitized images with CAD markers (*). Architectural distortion is identified in both views and was histologically related to ILC. An extra mark (arrow) is seen in the lateral left breast in the craniocaudal view only (left images). No major abnormality was found by the interpreting radiologist in this area. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) confirm parenchymal distortion (arrows) at the 12-o'clock position.
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Figure 2d. Current screening mammogram obtained in a 74-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show a subtle 1.5-cm area of architectural distortion and asymmetric density (arrow) in the posterior central portion of the left breast, seen best in a. (c) Low-resolution digitized images with CAD markers (*). Architectural distortion is identified in both views and was histologically related to ILC. An extra mark (arrow) is seen in the lateral left breast in the craniocaudal view only (left images). No major abnormality was found by the interpreting radiologist in this area. (d) Digitally magnified images (craniocaudal on the left, mediolateral oblique on the right) confirm parenchymal distortion (arrows) at the 12-o'clock position.
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Figure 3a. Mammograms show an ILC detected at screening in a 67-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show the malignant lesion detected by the interpreting radiologist as a 1.2-cm asymmetric density (arrow) on the upper outer quadrant of the right breast. (c) This ILC is marked by CAD (*) in both views. Also marked are areas of benign calcification ( ) in both breasts and a benign mass (arrow) in the left breast. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) demonstrate density (arrows).
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Figure 3b. Mammograms show an ILC detected at screening in a 67-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show the malignant lesion detected by the interpreting radiologist as a 1.2-cm asymmetric density (arrow) on the upper outer quadrant of the right breast. (c) This ILC is marked by CAD (*) in both views. Also marked are areas of benign calcification () in both breasts and a benign mass (arrow) in the left breast. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) demonstrate density (arrows).
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Figure 3c. Mammograms show an ILC detected at screening in a 67-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show the malignant lesion detected by the interpreting radiologist as a 1.2-cm asymmetric density (arrow) on the upper outer quadrant of the right breast. (c) This ILC is marked by CAD (*) in both views. Also marked are areas of benign calcification () in both breasts and a benign mass (arrow) in the left breast. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) demonstrate density (arrows).
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Figure 3d. Mammograms show an ILC detected at screening in a 67-year-old woman. (a) Craniocaudal and (b) mediolateral oblique views show the malignant lesion detected by the interpreting radiologist as a 1.2-cm asymmetric density (arrow) on the upper outer quadrant of the right breast. (c) This ILC is marked by CAD (*) in both views. Also marked are areas of benign calcification () in both breasts and a benign mass (arrow) in the left breast. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) demonstrate density (arrows).
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Figure 4a. Mammograms obtained in the same patient as in Figure 3 14 months before detection of an ILC. In routine (a) craniocaudal and (b) mediolateral oblique views, the lesion (arrow) in the upper outer quadrant in the right breast is present but smaller than that in the later images (Fig 3a, 3b). (c) The lesion (*) is marked by the CAD system in both views. Additional marks (arrows pointing to *) on areas judged by the interpreting radiologist as not suspicious are noted in the left breast. = benign calcifications. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) reveal possible spiculation (arrow).
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Figure 4b. Mammograms obtained in the same patient as in Figure 3 14 months before detection of an ILC. In routine (a) craniocaudal and (b) mediolateral oblique views, the lesion (arrow) in the upper outer quadrant in the right breast is present but smaller than that in the later images (Fig 3a, 3b). (c) The lesion (*) is marked by the CAD system in both views. Additional marks (arrows pointing to *) on areas judged by the interpreting radiologist as not suspicious are noted in the left breast. = benign calcifications. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) reveal possible spiculation (arrow).
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Figure 4c. Mammograms obtained in the same patient as in Figure 3 14 months before detection of an ILC. In routine (a) craniocaudal and (b) mediolateral oblique views, the lesion (arrow) in the upper outer quadrant in the right breast is present but smaller than that in the later images (Fig 3a, 3b). (c) The lesion (*) is marked by the CAD system in both views. Additional marks (arrows pointing to *) on areas judged by the interpreting radiologist as not suspicious are noted in the left breast. = benign calcifications. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) reveal possible spiculation (arrow).
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Figure 4d. Mammograms obtained in the same patient as in Figure 3 14 months before detection of an ILC. In routine (a) craniocaudal and (b) mediolateral oblique views, the lesion (arrow) in the upper outer quadrant in the right breast is present but smaller than that in the later images (Fig 3a, 3b). (c) The lesion (*) is marked by the CAD system in both views. Additional marks (arrows pointing to *) on areas judged by the interpreting radiologist as not suspicious are noted in the left breast. = benign calcifications. (d) Digitally magnified views (craniocaudal on the left, mediolateral oblique on the right) reveal possible spiculation (arrow).
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Copyright © 2002 by the Radiological Society of North America.
