Katie M. Davis, DO; Wendie A. Berg, MD, PhD, FACR, FSBI
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Synonyms
Ductal enhancement
Definitions
Nonmass enhancement (NME): Enhancement discrete from background that is neither focus nor mass
Linear: Describes distribution of NME
Arrayed in line (linear) or line that branches (linear branching)
Distinguish from segmental distribution: Triangle or cone of enhancement with apex pointing to nipple, involving lobe/segment of breast
Characterize internal enhancement pattern of NME
Homogeneous: Confluent, uniform
Heterogeneous: Nonuniform, random pattern, intervening normal parenchyma or fat
Clumped: Cobblestone pattern, various shapes and sizes, occasionally confluent; suspicious for DCIS
Clustered ring: Thin rings clustered in periductal stroma; suspicious for DCIS
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
DIAGNOSTIC CHECKLIST
Consider
Selected References
Asada T et al: Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy. Jpn J Radiol. 36(3):200-208, 2018
Dratwa C et al: Breast MR biopsy: pathological and radiological correlation. Eur Radiol. 26(8):2510-9, 2016
Machida Y et al: Two distinct types of linear distribution in nonmass enhancement at breast MR imaging: difference in positive predictive value between linear and branching patterns. Radiology. 276(3):686-94, 2015
Greenwood HI et al: Ductal carcinoma in situ of the breasts: review of MR imaging features. Radiographics. 33(6):1569-88, 2013
Morris EA, Comstock CE, Lee CH, et al. ACR BI-RADS® Magnetic Resonance Imaging. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013
Tozaki M: BI-RADS-MRI terminology and evaluation of intraductal carcinoma and ductal carcinoma in situ. Breast Cancer. 20(1):13-20, 2013
Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
Sohns C et al: Value of the BI-RADS classification in MR-Mammography for diagnosis of benign and malignant breast tumors. Eur Radiol. 21(12):2475-83, 2011
Mossa-Basha M et al: Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation. Radiographics. 30(6):1673-87, 2010
Lee SH et al: Correlation between high resolution dynamic MR features and prognostic factors in breast cancer. Korean J Radiol. 9(1):10-8, 2008
Sakamoto N et al: Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer. 15(3):241-6, 2008
Jansen SA et al: Pure ductal carcinoma in situ: kinetic and morphologic MR characteristics compared with mammographic appearance and nuclear grade. Radiology. 245(3):684-91, 2007
Kuhl CK et al: MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 370(9586):485-92, 2007
Van Goethem M et al: MR mammography is useful in the preoperative locoregional staging of breast carcinomas with extensive intraductal component. Eur J Radiol. 62(2):273-82, 2007
Schnall MD et al: Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology. 238(1):42-53, 2006
Morakkabati-Spitz N et al: Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI. Eur Radiol. 15(9):2010-7, 2005
Liberman L et al: Ductal enhancement on MR imaging of the breast. AJR Am J Roentgenol. 181(2):519-25, 2003
Liberman L et al: Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol. 179(1):171-8, 2002
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Synonyms
Ductal enhancement
Definitions
Nonmass enhancement (NME): Enhancement discrete from background that is neither focus nor mass
Linear: Describes distribution of NME
Arrayed in line (linear) or line that branches (linear branching)
Distinguish from segmental distribution: Triangle or cone of enhancement with apex pointing to nipple, involving lobe/segment of breast
Characterize internal enhancement pattern of NME
Homogeneous: Confluent, uniform
Heterogeneous: Nonuniform, random pattern, intervening normal parenchyma or fat
Clumped: Cobblestone pattern, various shapes and sizes, occasionally confluent; suspicious for DCIS
Clustered ring: Thin rings clustered in periductal stroma; suspicious for DCIS
IMAGING
General Features
Mammographic Findings
Ultrasonographic Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
DIAGNOSTIC CHECKLIST
Consider
Selected References
Asada T et al: Grading system to categorize breast MRI using BI-RADS 5th edition: a statistical study of non-mass enhancement descriptors in terms of probability of malignancy. Jpn J Radiol. 36(3):200-208, 2018
Dratwa C et al: Breast MR biopsy: pathological and radiological correlation. Eur Radiol. 26(8):2510-9, 2016
Machida Y et al: Two distinct types of linear distribution in nonmass enhancement at breast MR imaging: difference in positive predictive value between linear and branching patterns. Radiology. 276(3):686-94, 2015
Greenwood HI et al: Ductal carcinoma in situ of the breasts: review of MR imaging features. Radiographics. 33(6):1569-88, 2013
Morris EA, Comstock CE, Lee CH, et al. ACR BI-RADS® Magnetic Resonance Imaging. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013
Tozaki M: BI-RADS-MRI terminology and evaluation of intraductal carcinoma and ductal carcinoma in situ. Breast Cancer. 20(1):13-20, 2013
Lee SJ et al: MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol. 197(3):755-62, 2011
Sohns C et al: Value of the BI-RADS classification in MR-Mammography for diagnosis of benign and malignant breast tumors. Eur Radiol. 21(12):2475-83, 2011
Mossa-Basha M et al: Ductal carcinoma in situ of the breast: MR imaging findings with histopathologic correlation. Radiographics. 30(6):1673-87, 2010
Lee SH et al: Correlation between high resolution dynamic MR features and prognostic factors in breast cancer. Korean J Radiol. 9(1):10-8, 2008
Sakamoto N et al: Categorization of non-mass-like breast lesions detected by MRI. Breast Cancer. 15(3):241-6, 2008
Jansen SA et al: Pure ductal carcinoma in situ: kinetic and morphologic MR characteristics compared with mammographic appearance and nuclear grade. Radiology. 245(3):684-91, 2007
Kuhl CK et al: MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet. 370(9586):485-92, 2007
Van Goethem M et al: MR mammography is useful in the preoperative locoregional staging of breast carcinomas with extensive intraductal component. Eur J Radiol. 62(2):273-82, 2007
Schnall MD et al: Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology. 238(1):42-53, 2006
Morakkabati-Spitz N et al: Diagnostic usefulness of segmental and linear enhancement in dynamic breast MRI. Eur Radiol. 15(9):2010-7, 2005
Liberman L et al: Ductal enhancement on MR imaging of the breast. AJR Am J Roentgenol. 181(2):519-25, 2003
Liberman L et al: Breast lesions detected on MR imaging: features and positive predictive value. AJR Am J Roentgenol. 179(1):171-8, 2002
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