{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:29:40Z","timestamp":1783528180030,"version":"3.55.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BD"],"published-print":{"date-parts":[[2022,6,30]]},"abstract":"<jats:p>OBJECTIVES: High background parenchymal enhancement (BPE) levels and asymmetric distribution could cause diagnostic uncertainty due to morphological similarity to breast cancer, especially invasive lobular carcinoma (ILC). We investigated BPE in ILC patients, its association with the tumor hormonal profile, and the effect of endocrine treatment (ET). METHODS: The analysis included all MRI examinations performed at our institution between 2010 and 2019 for ILC-diagnosed patients. Baseline study and the first follow-up study were reviewed. Digital medical records were reviewed to retrieve demographics\/pathology results\/treatment information. BPE and fibroglandular tissue were assessed qualitatively on the contralateral breast according to the criteria of the Breast Imaging Reporting and Data System (BI-RADS). RESULTS: The study included 129 patients. Most (91%) had pure ILC. All received ET; 12% also received chemotherapy; 90% had surgery first; 70% by breast conservation. On the baseline MRI, 70% had mild or moderate BPE; whereas, on the follow-up study, the majority (59%) had minimal BPE. Most BPE reductions were by 2 degrees. In the baseline study, additional biopsies were required in 59% of cases, and in 17%, a short-term follow-up was recommended. In the follow-up study, biopsies were recommended in 10%, and a short-term follow-up was requested in 16%. A correlation between progesterone receptor intensity index and baseline BPE level was observed (r =\u00a00.3, p =\u00a00.004). CONCLUSION: ILC patients usually exhibit high BPE. ET decreases BPE, and therefore may decrease false-positive interpretations. Additional research is needed to explore whether study can be performed on ET without compromising sensitivity. Key points: \u2219 High background parenchymal enhancement levels reduces breast MRI sensitivity, yielding high false positive rates especially when reporting cases of invasive lobular carcinoma [ILC]. \u2219Treatment of ILC with endocrine therapy reduces background parenchymal enhancement and thus could decrease these false-positive interpretations.<\/jats:p>","DOI":"10.3233\/bd-220003","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T11:10:52Z","timestamp":1656673852000},"page":"317-323","source":"Crossref","is-referenced-by-count":2,"title":["MRI background parenchymal enhancement in patients with invasive lobular carcinoma: Endocrine hormonal treatment effect"],"prefix":"10.1177","volume":"41","author":[{"given":"Ahuva","family":"Grubstein","sequence":"first","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yael","family":"Rapson","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moran","family":"Manor","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rinat","family":"Yerushalmi","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo","family":"Gavrieli","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomit","family":"Tamir","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagit","family":"Meshulam","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Atar","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salomon M.","family":"Stemmer","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzippy","family":"Shochat","sequence":"additional","affiliation":[{"name":", , , , Tel Aviv University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanir M.","family":"Allweis","sequence":"additional","affiliation":[{"name":", , , The Hebrew University, , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"issue":"1","key":"10.3233\/BD-220003_ref1","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1148\/rg.341135034","article-title":"Background parenchymal enhancement at breast MR imaging: Normal patterns, diagnostic challenges, and potential for false-positive and false-negative interpretation","volume":"34","author":"Giess","year":"2014","journal-title":"Radiographics"},{"issue":"1","key":"10.3233\/BD-220003_ref2","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1148\/radiology.203.1.9122382","article-title":"Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: Normal contrast medium enhancement and cyclical-phase dependency","volume":"203","author":"Kuhl","year":"1997","journal-title":"Radiology"},{"issue":"4","key":"10.3233\/BD-220003_ref3","doi-asserted-by":"crossref","first-page":"W373","DOI":"10.2214\/AJR.10.6272","article-title":"Background parenchymal enhancement on breast MRI: Impact on diagnostic performance","volume":"198","author":"DeMartini","year":"2012","journal-title":"AJR Am J Roentgenol"},{"issue":"12","key":"10.3233\/BD-220003_ref4","doi-asserted-by":"crossref","first-page":"2641","DOI":"10.1007\/s00330-012-2553-8","article-title":"Impact of menopausal status on background parenchymal enhancement and fibroglandular tissue on breast MRI","volume":"22","author":"King","year":"2012","journal-title":"Eur Radiol"},{"issue":"2","key":"10.3233\/BD-220003_ref5","doi-asserted-by":"crossref","first-page":"399","DOI":"10.2214\/ajr.176.2.1760399","article-title":"MR Imaging of the breast in patients with invasive lobular carcinoma","volume":"176","author":"Weinstein","year":"2001","journal-title":"Am J Roentgenol"},{"issue":"1","key":"10.3233\/BD-220003_ref6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.ejca.2007.10.009","article-title":"Invasive lobular carcinoma of the breast: Response to hormonal therapy and outcomes","volume":"44","author":"Rakha","year":"2008","journal-title":"Eur J Cancer"},{"key":"10.3233\/BD-220003_ref7","doi-asserted-by":"crossref","unstructured":"Pramod N, Nigam A, Basree M , Comprehensive review of molecular mechanisms and clinical features of invasive lobular cancer, Oncologist, 2021. 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