What is the best imaging modality for evaluating invasive lobular carcinoma?

• A. Mammography
• B. Ultrasound
• C. MRI
• D. PET-CT

Answer: (C)

Invasive lobular carcinoma often grows in a diffuse, infiltrative pattern and may not form a discrete mass or visible calcifications. That makes it harder to detect and gauge the full extent with mammography or ultrasound. Magnetic resonance imaging excels here because dynamic contrast-enhanced MRI highlights subtle enhancement patterns and provides a clearer map of the actual tumor extent, including multifocality and possible contralateral involvement. This superior sensitivity is especially valuable for surgical planning, reducing the risk of underestimating disease. PET-CT isn’t used for assessing local extent, and while mammography and ultrasound are useful, they can miss the full burden of ILC.