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Click 43 year-old, black female with the discoid variant of SLE who would soon be diagnosed with the rare manifestation of lupus mastitis. This image stack from August 2009 corresponds with Figure 7a and includes axial T1 pre-contrast non-fat-saturated images which demonstrate coarse calcifications visible on the previously shown mammograms; however the dense bilateral parenchymal tissue hides the LM. For Breast MRI, we use the following protocol. IV Contrast enhanced MRI of both breasts are performed on a Siemens TrioTrim 3.0 Tesla Magnet using a 7 channel; InVivo Breast Array MR coil with the following pulse sequences: 3 Plane Localizer, T2 TIRM (STIR) Axial BLADE (FOV 340; Time to Repetition [TR] 11070; Time to Echo [TE] 137; 3 mm @ .8 mm Time = 4:49), Axial T1 FL3D (FOV 340; TR 6.7; TE 2.63; 1.5mm @ 20% Time = 1:02), Axial T1 FL3D (Q-fat saturation technique; FOV 340; TR 4.0; TE 1.4; 1.00 mm @ 20% Time = 6:31 - 1 run without and the remaining 5 runs after contrast administration), and Sagittal T1 (FOV 240; TR 4.35; TE 1.75; 2.0 mm @ 20% Time = 2:04). Images are reviewed on a dedicated DynaCad workstation.

Click 43 year-old, black female with the discoid variant of SLE who would soon be diagnosed with the rare manifestation of lupus mastitis. This image stack from August 2009 corresponds with Figure 7b and includes axial BLADE (STIR) images which demonstrate scattered fibrocystic changes adjacent to the subtle, peripheral, high intensity signal surrounding the LM in the left breast (arrowhead). For Breast MRI, we use the following protocol. IV Contrast enhanced MRI of both breasts are performed on a Siemens TrioTrim 3.0 Tesla Magnet using a 7 channel; InVivo Breast Array MR coil with the following pulse sequences: 3 Plane Localizer, T2 TIRM (STIR) Axial BLADE (FOV 340; Time to Repetition [TR] 11070; Time to Echo [TE] 137; 3 mm @ .8 mm Time = 4:49), Axial T1 FL3D (FOV 340; TR 6.7; TE 2.63; 1.5mm @ 20% Time = 1:02), Axial T1 FL3D (Q-fat saturation technique; FOV 340; TR 4.0; TE 1.4; 1.00 mm @ 20% Time = 6:31 - 1 run without and the remaining 5 runs after contrast administration), and Sagittal T1 (FOV 240; TR 4.35; TE 1.75; 2.0 mm @ 20% Time = 2:04). Images are reviewed on a dedicated DynaCad workstation.

Click 43 year-old, black female with the discoid variant of SLE who would soon be diagnosed with the rare manifestation of lupus mastitis. This image stack from August 2009 corresponds with Figure 7c (and 8a) and includes Sagittal delayed post-contrast GRE images of the left breast which demonstrate a 5.6 cm, heterogeneous mass with a peripheral, irregular, rim of enhancement. The thickest dimension of peripheral enhancement located superiorly measures 13 mm. For Breast MRI, we use the following protocol. IV Contrast enhanced MRI of both breasts are performed on a Siemens TrioTrim 3.0 Tesla Magnet using a 7 channel; InVivo Breast Array MR coil with the following pulse sequences: 3 Plane Localizer, T2 TIRM (STIR) Axial BLADE (FOV 340; Time to Repetition [TR] 11070; Time to Echo [TE] 137; 3 mm @ .8 mm Time = 4:49), Axial T1 FL3D (FOV 340; TR 6.7; TE 2.63; 1.5mm @ 20% Time = 1:02), Axial T1 FL3D (Q-fat saturation technique; FOV 340; TR 4.0; TE 1.4; 1.00 mm @ 20% Time = 6:31 - 1 run without and the remaining 5 runs after contrast administration), and Sagittal T1 (FOV 240; TR 4.35; TE 1.75; 2.0 mm @ 20% Time = 2:04). Images are reviewed on a dedicated DynaCad workstation.

Click 43 year-old, black female with the discoid variant of SLE who would soon be diagnosed with the rare manifestation of lupus mastitis. This image stack from June 2010 corresponds with Figure 8b and includes Sagittal delayed post-contrast GRE images of the left breast which demonstrate a 5.6 cm, heterogeneous mass with a peripheral, irregular, slightly interrupted, rim of enhancement. The thickest dimension of peripheral enhancement located superiorly measures 12 mm. For Breast MRI, we use the following protocol. IV Contrast enhanced MRI of both breasts are performed on a Siemens TrioTrim 3.0 Tesla Magnet using a 7 channel; InVivo Breast Array MR coil with the following pulse sequences: 3 Plane Localizer, T2 TIRM (STIR) Axial BLADE (FOV 340; Time to Repetition [TR] 11070; Time to Echo [TE] 137; 3 mm @ .8 mm Time = 4:49), Axial T1 FL3D (FOV 340; TR 6.7; TE 2.63; 1.5mm @ 20% Time = 1:02), Axial T1 FL3D (Q-fat saturation technique; FOV 340; TR 4.0; TE 1.4; 1.00 mm @ 20% Time = 6:31 - 1 run without and the remaining 5 runs after contrast administration), and Sagittal T1 (FOV 240; TR 4.35; TE 1.75; 2.0 mm @ 20% Time = 2:04). Images are reviewed on a dedicated DynaCad workstation.

Click 43 year-old, black female with the discoid variant of SLE who would soon be diagnosed with the rare manifestation of lupus mastitis. This image stack from December 2010 corresponds with Figure 8c and includes Sagittal delayed post-contrast GRE images of the left breast which demonstrate a 5.6 cm, heterogeneous mass with a peripheral, irregular, interrupted, rim of enhancement. The thickest dimension of peripheral enhancement located superiorly has decreased to 8 mm as the patient has been actively compliant with her medications. For Breast MRI, we use the following protocol. IV Contrast enhanced MRI of both breasts are performed on a Siemens TrioTrim 3.0 Tesla Magnet using a 7 channel; InVivo Breast Array MR coil with the following pulse sequences: 3 Plane Localizer, T2 TIRM (STIR) Axial BLADE (FOV 340; Time to Repetition [TR] 11070; Time to Echo [TE] 137; 3 mm @ .8 mm Time = 4:49), Axial T1 FL3D (FOV 340; TR 6.7; TE 2.63; 1.5mm @ 20% Time = 1:02), Axial T1 FL3D (Q-fat saturation technique; FOV 340; TR 4.0; TE 1.4; 1.00 mm @ 20% Time = 6:31 - 1 run without and the remaining 5 runs after contrast administration), and Sagittal T1 (FOV 240; TR 4.35; TE 1.75; 2.0 mm @ 20% Time = 2:04). Images are reviewed on a dedicated DynaCad workstation.

Click 43 year-old, black female with the discoid variant of SLE who would soon be diagnosed with the rare manifestation of lupus mastitis. This image stack from October 2011 corresponds with Figure 8d and includes Sagittal delayed post-contrast GRE images of the left breast which demonstrate a 5.6 cm, heterogeneous mass with a peripheral, irregular, interrupted, rim of enhancement. The thickest dimension of peripheral enhancement located superiorly has decreased further to 5 mm as the patient has been actively compliant with her medications and is now asymptomatic. For Breast MRI, we use the following protocol. IV Contrast enhanced MRI of both breasts are performed on a Siemens TrioTrim 3.0 Tesla Magnet using a 7 channel; InVivo Breast Array MR coil with the following pulse sequences: 3 Plane Localizer, T2 TIRM (STIR) Axial BLADE (FOV 340; Time to Repetition [TR] 11070; Time to Echo [TE] 137; 3 mm @ .8 mm Time = 4:49), Axial T1 FL3D (FOV 340; TR 6.7; TE 2.63; 1.5mm @ 20% Time = 1:02), Axial T1 FL3D (Q-fat saturation technique; FOV 340; TR 4.0; TE 1.4; 1.00 mm @ 20% Time = 6:31 - 1 run without and the remaining 5 runs after contrast administration), and Sagittal T1 (FOV 240; TR 4.35; TE 1.75; 2.0 mm @ 20% Time = 2:04). Images are reviewed on a dedicated DynaCad workstation.