LBCA asked our Scientific Advisory Board (SAB) members to provide answers to some of the frequently asked questions (FAQ’s) that come up about lobular breast cancer. The answer to the below question is from SAB Member Dr. Maxine Jochelson, Medical Director of Women’s Imaging Breast Link Beverly Hills and Vice President of Beverly Radiology Medical Group/RADNET.

Question: What is a Whole Body MRI and How is it Useful for an ILC Patient?

Answer:

A Whole-Body MRI (WB-MRI) can be a valuable tool for staging invasive lobular carcinoma (ILC), particularly for detecting metastatic disease, as ILC can be difficult to visualize on mammograms and even some other imaging modalities due to its characteristic diffuse, single-file growth pattern. ILC also exhibits low uptake of FDG (a radiotracer used in a commonly used type of PET scan). This makes FDG/PET less effective for staging of ILC as compared to other breast cancer types. 

WB-MRI has a high contrast resolution and enables comprehensive anatomical coverage to identify metastatic sites in organs like the liver, bones, and gastrointestinal tract, potentially leading to changes in treatment plans. Because of the high resolution, it can detect metastatic lesions that might be missed with routine imaging. WB-MRI also offers functional assessment, which means that it can evaluate how body tissues and organs are working, not just what they look like structurally. This is helpful especially in the case of bone-predominant metastatic ILC, where CT can be limited.

Preliminary study suggests that WB-MRI also seems to provide benefits in ILC staging. It can identify more sites of metastatic disease in ILC, often in the liver and bones, compared to conventional imaging and can reveal disease progression earlier than CT or bone sintigraphy which enables quicker adjustments to systemic therapy. While this holds promise for ILC staging, it has so far predominantly been used on only a case-by-case basis, with patients with suspected or confirmed metastatic disease. WWB-MRI is also proving to be a powerful complement to other imaging techniques like FDG-PET/CT, in that together the imaging modalities provide a more comprehensive picture of the extent of the disease. According to a review on NIH.gov, 1 the findings from WB-MRI have led to a greater number of treatment changes in patients with ILC compared to patients with invasive ductal carcinoma (IDC). 

While research suggests a benefit in detecting disease progression and informing treatment decisions, large randomized studies are still needed to fully evaluate the benefit of WB-MRI as a primary diagnostic tool or staging tool for ILC and to understand its impact on patient outcomes.1,2. 

Read more about WB MRI in these articles: