MR Imaging-Guided Sonography Followed by Fine-Needle Aspiration Cytology in Occult Carcinoma of the Breast

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Abstract
OBJECTIVE. In patients with axillary metastases as clinical evidence of possible occult breast cancer, a combined approach of MR imaging, sonography, and aspiration biopsy cytology was evaluated.SUBJECTS AND METHODS. Thirty-one women with metastatic adenocarcinoma in their axillary lymph nodes originating from an unknown primary site underwent MR imaging of the breast because physical examination and mammography findings were normal. Twenty of the 31 women had no history of malignancy, 10 had been previously treated for contralateral breast cancer, and one patient had nodal metastases in the contralateral axilla at the time breast cancer was detected. When a contrast-enhancing lesion was revealed on MR imaging of the breast, sonography and fine-needle aspiration cytology were also performed.RESULTS. MR imaging revealed the primary breast cancer in eight (40%) of the 20 patients without a history of malignancy. MR imaging of the breast revealed a second primary cancer in three (27%) of the 11 patients with...