Investig Magn Reson Imaging.  2015 Jun;19(2):127-130. 10.13104/imri.2015.19.2.127.

Ductal Carcinoma in situ with Multicystic Changes in a Patient with Interstitial Mammoplasty via Paraffin Injection: MRI and Pathological Findings

• Park J
• Woo OH
• Kim C
• Cho KR
• Seo BK

• KMID: 2175594
• DOI: http://doi.org/10.13104/imri.2015.19.2.127

Abstract

Direct injection of foreign material, such as liquid paraffin and silicone, into the breast can induce a foreign body granulomatous reaction and fibrosis, resulting in hard, nodular breast masses and architectural distortion that can mimic neoplasm. Conventional methods, including physical examination, mammography, and ultrasonography are of little use to differentiate between foreign body-induced mastopathy and breast cancer. In patients with foreign body injection such as breast augmentation, dynamic contrast enhanced MR imaging is an excellent imaging modality. Here, the authors report the MR imaging and pathological findings of ductal carcinoma in situ (DCIS) with multicystic changes in a 41-year-old woman with a previous history of interstitial mammoplasty by paraffin injection.

Keyword

DCIS; Breast augmentation via Paraffin; Magnetic resonance imaging (MRI)

MeSH Terms

Adult
Breast
Breast Neoplasms
Carcinoma, Intraductal, Noninfiltrating*
Female
Fibrosis
Foreign Bodies
Humans
Magnetic Resonance Imaging*
Mammaplasty*
Mammography
Mineral Oil
Paraffin*
Physical Examination
Silicones
Ultrasonography
Mineral Oil
Paraffin
Silicones

Figure

• 

  Fig. 1 A 41-year-old woman with DCIS and a previous interstitial mammoplasty via paraffin injection. (a) Axial pre-contrast enhanced T1-weighted, (b) fat-suppressed T1-weighted, (c) T2-weighted MR images of the right breast showing an approximate 4.0 × 4.9 cm sized, multicystic mass. Multifocal, well-circumscribed nodular lesions were observed (arrows) in the subcutaneous layer of both breasts on (d) axial pre-contrast enhanced T1-weighted, and (e) fat-suppressed T1-weighted images. (f) Well-enhancing mural nodules and septa are seen on an axial post-contrast enhanced T1-weighted fat-suppressed MR image of the right breast. (g) Photomicrograph of the histopathological specimen showing ductal carcinoma in situ, with a micropapillary pattern and epithelial projection into the duct lumen, lacking a fibrovascular core (Hematoxylin & Eosin staining, × 100; total extent of DCIS on pathology, roughly 2.5 × 2.4 cm). (h) Photomicrograph of the histopathological specimen showing lipogranuloma (Hematoxylin & Eosin staining, × 100).

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