Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings

Yang, Wei Tse; Le-Petross, Huong T.; Macapinlac, Homer A.; Çarkaci, Selin; González-Angulo, Ana M.; Dawood, Shaheenah; Resetkova, Erika; Hortobágyi, Gabriel N.; Cristofanilli, Massimo

doi:10.1007/s10549-007-9671-z

Cited by 201 publications

(166 citation statements)

References 22 publications

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“…MRI is highly sensitive for depicting primary breast parenchymal lesions and global skin abnormalities that may help diagnose inflammatory breast cancer. Lesions that were either heterogeneous or inhomogeneous, consisting of a reticular or dendritic internal enhancement with a washout or plateau kinetic curve, were commonly noted [26][27][28][29]. This is different from our findings in non-puerperal mastitis.…”

Section: Discussioncontrasting

confidence: 99%

“…Clinically, inflammatory breast cancer is characterised by the rapid onset of swelling and enlargement of the breast, the characteristic "peau d'orange" (orange peel) skin appearance and quick progression to nodules and ulcerations. This type of breast cancer is usually poorly differentiated in histology from infiltrating ductal carcinoma, which often has distant metastases at the time of diagnosis [8,26]. These aforementioned manifestations in non-puerperal mastitis are slight or rare [8].…”

Section: Discussionmentioning

confidence: 99%

“…These aforementioned manifestations in non-puerperal mastitis are slight or rare [8]. Inflammatory breast cancer usually affects females of approximately 50 years old [26,27], but non-puerperal mastitis is more common in females under 40 [5,10,11,13]. MRI is highly sensitive for depicting primary breast parenchymal lesions and global skin abnormalities that may help diagnose inflammatory breast cancer.…”

Section: Discussionmentioning

confidence: 99%

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Radiological and clinical features of adult non-puerperal mastitis

Tan¹,

Li²,

Peng³

et al. 2013

BJR

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Objective: To describe the radiological and clinical features of adult non-puerperal mastitis and to determine the most accurate method of preventing unnecessary surgical procedures.Methods: Clinical and imaging findings were retrospectively reviewed in 51 females with non-puerperal mastitis, which was confirmed by biopsy/surgical pathology. All 51 patients had pre-operative MRI; 45 patients also had sonograms and 25 also had mammograms, pre-operatively.Results: Of the 51 cases with non-puerperal mastitis, 94.1% (48/51) were confirmed as having acute or chronic inflammation, and the other 3 had plasma cell mastitis; areola papillaris inflammation was found in 39.2% (20/51) of the cases. Overall, 6 of the 25 cases that were examined with mammography and 2 of the 45 cases that were examined with sonography appeared normal, but all 51 lesions were positively identified on MRI. Asymmetrical density (12/25) on mammograms and solitary or separated/ contiguous, clustered, hypoechoic mass-like lesions (31/45) on ultrasound were the most common signs of non-puerperal mastitis. On enhanced MRI, 90.2% (46/51) of patients showed non-mass-like enhanced lesions. Multiple regional enhancements in the pattern of distribution (32/46) and separated or contiguous, clustered, rim-like enhancements in the pattern of internal enhancement (29/46) were the most common manifestations in nonmass-like enhanced lesions. Of the 51 patients, mastitis Type 1 and Type 2 in the time-signal intensity curve were detected in 47.1% and 51.0% of the patients, respectively. The breast imaging reporting and data system categories with the highest number of patients were Category 0 (9/ 25) on mammography, Category 4a on sonography (18/45) and Category 4a on MRI (29/51). Conclusion:The findings from mammography and ultrasound are non-specific; therefore, using MR can be helpful in the diagnosis, especially in the presence of non-mass-like enhancements that are multiple, regional, separated, or contiguous, clustered and rim-like.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Radiological and clinical features of adult non-puerperal mastitis

Tan¹,

Li²,

Peng³

et al. 2013

BJR

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“…It is common clinical practice in patients with breast cancer to carry out ultrasound of the axilla together with fine needle aspiration cytology of any suspicious axillary nodes that are identified (or palpable) prior to patients undergoing SNB [10]. Similarly MRI [11,32], CT [33,34], mammography [7,11] and other non-PET radionuclides (MIBI) [25] have all been suggested as useful in the staging of the axilla. It would not be the aim to perform a complete review of all modalities at this stage, since an extensive number of studies have not been carried out in all modalities.…”

Section: Introductionmentioning

confidence: 99%

The use of FDG-PET in assessing axillary lymph node status in breast cancer: a systematic review and meta-analysis of the literature

Peare

Staff

Heys

2010

Breast Cancer Res Treat

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International audienceAxillary lymph node status is the most powerful prognostic indicator in patients with breast cancer. FDG-PET has been suggested as a non-invasive method of staging the axilla. The aim of this study was to review and aggregate all studies that measured the performance of FDG-PET in patients with breast cancer, using surgically obtained axillary histology as a reference, in a meta-analysis. A systematic review of the literature was performed and data extracted from all eligible studies. These were then analysed using meta-analysis software and summary receiver operating characteristic (SROC) curves were plotted for the aggregate data. The data was then tested to determine which parameters impacted on the sensitivity and specificity of the studies. Sensitivities ranging from 20 to 100% and specificities ranging from 65 to 100% have been reported. An aggregated ROC analysis found an area under the curve of 0.95 (95% CI 0.91–0.97) and a * value of 0.89 (95% CI 0.85–0.92) in a total of 25 studies involving 2,460 patients. The AUC and * values indicated little difference between the compared study characteristics. The performance of the technique currently remains below, which is required to replace assessment of axillary node status by surgical biopsy and histological assessment. However, sensitivity and specificity are high and FDG-PET may have a role to play under particular circumstances. Moreover, the additional benefit of an assessment of distal metastatic spread provided by FDG-PET requires further investigation

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“…For the initial staging work-up, many conventional imaging modalities, such as X-ray mammography, MR mammography, chest plain radiography, bone scintigraphy, and breast, axillary and liver ultrasonography, have been widely utilized. In recent years, several groups have evaluated the clinical role of FDG-PET/CT for pretreatment evaluation of breast cancer in comparison with conventional imaging tools [18,39,[43][44][45][46][47][48][49][50][51][52][53][54] (Table 2). These studies revealed that FDG-PET/CT is generally helpful, but particularly valuable for detection of extra-axillary (infraclavicular, supraclavicular and internal mammary) nodal metastasis and occult distant metastasis relative to conventional modalities, especially in patients with inflammatory breast cancer [43,46,47] and stage II-III disease [18, Fig.…”

Section: Initial Stagingmentioning

confidence: 99%

Present and future role of FDG-PET/CT imaging in the management of breast cancer

Kitajima

Miyoshi

2016

Jpn J Radiol

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by malignant cells, opened a new field in clinical oncologic imaging. Recently, integrated positron emission tomography/computed tomography (PET/CT), in which a full-ringdetector clinical PET scanner and multidetector-row helical CT scanner are combined, has made it possible to acquire both metabolic and anatomic imaging data using a single device in a single diagnostic session, and provides precise anatomic localization of suspicious areas of increased FDG uptake. When used in a clinical setting, FDG-PET/CT leads to a significant improvement in diagnostic accuracy and has had a considerable impact on patient management, including diagnosis, initial staging, optimization of treatment, restaging, monitoring of the response to therapy, and prognostication of various malignant tumors. We herein review the current and future roles of FDG-PET/CT in the management of breast cancer, discussing its usefulness and limitations for imaging in these patients. DiagnosisFDG-PET imaging has poor sensitivity (<50 %) for subcentimeter breast cancers [9,10]. This is due to the limited spatial resolution of PET and, in some cases, by tumor characteristics (e.g., low FDG avidity in grade 1 cancer, ductal carcinoma in situ, or lobular carcinoma) [1,2]. Specificity can also be altered by variations of FDG uptake in certain benign conditions, such as infection, fibroadenoma, ductal adenoma, inflammatory granulomatous mastitis, and fibrocystic changes [3].In order to improve specificity, some authors would obtain a second series of PET images centered on the breast approximately 2 h after FDG injection (dual-time imaging) [4]. Indeed, FDG uptake seems to increase with time in the case of malignancy, while some inflammatory lesions show stable or decreasing uptake [4]. However, dual-time Abstract Integrated positron emission tomography/computed tomography (PET/CT) with 2-[18F]fluoro-2-deoxyd-glucose (FDG) is a useful tool for acquisition of both glucose metabolic and anatomic imaging data using a single device in a single diagnostic session, and has opened a new field in clinical oncologic imaging. FDG-PET/CT has been used successfully for the diagnosis, initial staging, restaging, early treatment response assessment, evaluation of metastatic disease response, and prognostication of breast cancer as well as various malignant tumors. We herein review the current place and role of FDG-PET/CT in the management of breast cancer, focusing on its usefulness and limitations in the imaging of these patients.

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Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings

Abstract: MRI was the most accurate imaging technique in detecting a primary BPL in IBC patients. Sonography can be useful in diagnosing regional nodal disease. PET/CT provides additional information on distant metastasis, and it should be considered in the initial staging of IBC.

Cited by 201 publications

References 22 publications

Radiological and clinical features of adult non-puerperal mastitis

Radiological and clinical features of adult non-puerperal mastitis

The use of FDG-PET in assessing axillary lymph node status in breast cancer: a systematic review and meta-analysis of the literature

Present and future role of FDG-PET/CT imaging in the management of breast cancer

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