Differentiation Between Granulomatous Lobular Mastitis and Breast Cancer Using Quantitative Parameters on Contrast-Enhanced Ultrasound

Abstract

ObjectiveTo investigate the Contrast-enhanced ultrasound (CEUS) imaging characteristics of granulomatous lobular mastitis (GLM) and the value of differentiating GLM from breast cancer.Materials and methodsThe study included 30 women with GLM (mean age 36.7 ± 5 years [SD]) and 58 women with breast cancer (mean age 48. ± 8 years [SD]) who were scheduled for ultrasound-guided tissue biopsy. All patients were evaluated with conventional US and CEUS prior to the biopsy. In both groups, the parameters of the quantitative and qualitative analysis of the CEUS were recorded and compared. The receiver-operating-characteristics curves (ROC) were created. Sensitivity, specificity, cut-off, and area under the curve (AUC) values were calculated.ResultsTTP values in GLM were statistically higher than in breast cancer (mean, 27.63 ± 7.29 vs. 20.10 ± 6.11), but WIS values were lower (mean, 0.16 ± 0.05 vs. 0.28 ± 0.17). Rich vascularity was discovered in 54.45% of breast cancer patients, but only 30.00% of GLM patients had rich vascularity. The AUC for the ROC test was 0.791 and 0.807, respectively. The optimal cut-off value for TTP was 24.5s, and the WIS cut-off value was 0.185dB/s, yielding 73.33% sensitivity, 84.48% specificity, and 86.21% sensitivity, 70% specificity respectively in the diagnosis of GLM. The lesion scores reduced from 4 to 3 with the addition of CEUS for the patients with GLM. However, the scores did not change for the patients with breast cancer.ConclusionCEUS could help distinguish GLM from breast cancer by detecting higher TTP and WIS values, potentially influencing clinical decision-making for additional biopsies.

The value of Demetics ultrasound‐assisted diagnosis system in diagnosis of breast lesions and in assessment Ki‐67 status of breast cancer

“…It is sometimes difficult to distinguish between special types of mastitis (such as Plasma Cell Mastitis and Granulomatous Mastitis) and breast cancer, as these inflammatory lesions can sometimes appear very similar to breast cancer on gray‐scale ultrasound imaging. We found that Demetics often confuses inflammatory lesions with malignant lesions, which require further information with clinical symptoms, hematological tests and other imaging techniques (such as elastography and contrast‐enhanced ultrasound) 21,22 . We recommend that radiologists can be flexible in adjusting classification based on the individual circumstances of patients when diagnosing inflammatory breast lesions, rather than being misled by Demetics results.…”

“…We found that Demetics often confuses inflammatory lesions with malignant lesions, which require further information with clinical symptoms, hematological tests and other imaging techniques (such as elastography and contrast-enhanced ultrasound). 21,22 We recommend that radiologists can be flexible in adjusting classification based on the individual circumstances of patients when diagnosing inflammatory breast lesions, rather than being misled by Demetics results. In addition, the histological components of breast adenosis are complex and can easily be compounded by other diseases.…”

Imaging features of breast cancer subtypes on contrast enhanced ultrasound: a feasibility study

“…It is readily available, easy to perform and a relatively inexpensive alternative to other modalities (MRI) used for perfusion assessment. It has been shown to overcome the limited signal-to-noise ratio and spatial resolution of Doppler USG in the evaluation of perfusion of the lesions and hence seems promising in the assessment of the perfusion characteristics of breast tumours [ 14 , 15 , 24 ].…”

Circulating miR-451a, miR-5571-3p, CLN6, HSD11B1 and PDE4 levels in differential diagnosis of Granulomatous lobular mastitis, breast cancer and breast fibroadenoma

“…Both GLM and BC typically present as breast masses with indistinct borders and rm consistency, and may be accompanied by enlarged ipsilateral axillary lymph nodes. Although modern research has improved the non-invasive differential diagnosis of GLM and BC through various radiological techniques, such as sonogram radiomics model 22 , contrast-enhanced ultrasound 23 , ultrasound elastography 24 , deep-learning based AI automatic classi cation system 25 , and ARFI elastography 26 , the gold standard for diagnosing GLM still requires tissue biopsy. In some cases, multiple biopsies may be necessary for clinical differential diagnosis.…”