The many MRI faces of invasive lobular carcinoma: a pictorial essay

Invasive lobular cancer is the second most common subtype of invasive breast cancer. Due to the wide diversity of histopathological, clinical, and radiological presentations, it can provide diagnostic and therapeutic challenges. Magnetic resonance imaging (MRI) has the highest sensitivity for its detection and the most accurate determination of invasive lobular cancer extent. The aim of our pictorial review was to demonstrate the different presentations of invasive lobular cancer on MRI and thus facilitate the interpretation of imaging findings for radiologists. The pictorial essay carefully extracted six different MRI presentations of an invasive lobular cancer with brief histopathological and clinical patient data. We showed that invasive lobular cancer presentation on MRI varied, ranged from a single focus to single and multiple lesions, non-mass enhancements of various distributions, and in some cases with nonspecific enhancement curves. This pictorial essay presented a spectrum of MRI findings of invasive lobular cancer, showing the variety of their appearances. Considering the variety of MRI imaging, the radiologist sometimes has to look for other diagnostic methods for the final interpretation of the imaging findings. We believe that the presentation of different cases will educate radiologists and help in making appropriate diagnostic and therapeutic decisions.