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Breast Imaging

E1136. Out of Breast Experiences: Extramammary Findings on Breast MRI

Rossett L,  Hussien R,  O'Connell A. University of Rochester Medical Center, Rochester, NY

Address correspondence to L. Rossett (leah_rossett@urmc.rochester.edu)

Background Information: MRI of the breast is used to detect and characterize breast disease, to assess extent of disease, and to evaluate response to treatment. Although breast MRI is a study with a narrow FOV focused on the mammary tissue and bilateral axillae, the anterior thorax and upper abdomen are also imaged and have their own anatomic variants and pathologic processes of which to be aware because of their potential effect on patient management.

Educational Goals/Teaching Points: The goals of this exhibit are to increase knowledge of and review anatomic common variants and extramammary disease processes incidentally imaged on breast MRI, and to remind that MRI has diagnostic limitations and artifacts that can and should affect assessment and interpretation of extramammary findings.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: This exhibit will address several issues including common anatomic variants incidentally imaged (sternalis muscle, azygous lobe, and left-sided or duplicated superior vena cava), incidental disease processes by anatomic location (liver [benign or malignant lesions], chest wall [trauma, skin lesions, and bone lesions], and lungs or pleura [atelectasis, pneumonia, pulmonary nodules or masses, and pleural effusions]), and MR artifacts (a quick reminder of artifacts that mimic pathology and limit assessment of extramammary findings).

Conclusion: Although breast MRI has a narrow FOV, the radiologist cannot ignore the important extramammary findings of the imaged anterior thorax and upper abdomen. A complete assessment of the imaged area with knowledge of anatomic variants, extramammary disease processes, and MR artifacts is necessary as these can affect patient management.