Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis. A comparative study

Abstract

The aim of this study was to evaluate the potential of magnetic resonance mammography (MRM) to distinguish inflammatory breast carcinomas (IBC) from acute mastitis (AM). This study compared MRM examinations of two selected groups of patients: 48 subjects with IBC and 42 patients with AM. No statistical differences were revealed between the two groups for morphology of masses and of non-mass-like enhancement, breast enlargement, diffuse skin thickening, abnormal nipple configuration, prominent vessels, and also for cutaneous/subcutaneous, perimamillar and diffuse oedema. However, initial and postinitial dynamic characteristics significantly differed between the two groups (p < 0.001). In IBC, more masses with a greater average size were detected (p < 0.05). The following morphological criteria were also observed more often in IBC (p < 0.05): T2-hypointensity of masses (77.5%/18.2%), blooming sign (62.5%/31.8%), infiltration of pectoralis major muscle (interruption of fat plane: 54.2%/16.7%; pathological enhancement: 33.3%/7.1%), perifocal (66.7%/33.3%), prepectoral (72.9%/31.0%) and intramuscular pectoral oedema (41.7%/7.1%). The main localisation of AM was subareolar, of IBC central or dorsal (p < 0.001). The discrimination between AM and IBC remains a diagnostic challenge because of overlapping imaging features. However, the combination of multiple dynamic and morphological MRM criteria seems to have the potential for a differential diagnosis.

Radiologic findings of idiopathic granulomatous mastitis

“…MRI findings of IGM are T2 hyperintensity, major contrast enhancement at subaerolar region, moderate or slow enhancement in an early phase and increased enhancement pattern or plato pattern in the late phase of contrast injection, absence of perifocal, prepectoral or pectoralis muscle edema and absence of findings suggesting pectoralis muscle invasion (nonvisualization of prepectoral fat planes or pathologic contrast enhancement of pectoralis muscle). These MRI findings together with an absence of mass on US and MG support the IGM [20][21]. In our study, MRI findings were similar to literature.…”

Inflammatory breast carcinoma and locally advanced breast carcinoma: characterisation with MR imaging

“…The most typical finding in IBC is skin involvement with diffuse changes, which previous authors have reported in 75% of cases [14,21]. Even in our series, the main typical feature of IBC was skin thickening which, together with oedema, was present in over 87% of cases.…”

“…In letteratura, alcuni lavori si sono occupati dei rilievi semeiotici del IBC [12][13][14][15][16][17][18][19][20], pochi di questi hanno trattato gli aspetti di imaging RM [12][13][14][15] e solo un recente lavoro analizza le manifestazioni RM del IBC e la diagnosi differenziale con il LABC [21]. Lo scopo di questo studio è quindi verificare l'esistenza di rilievi RM specifici di carcinoma infiammatorio e dimostrarne l'accuratezza statistica nella diagnosi differenziale tra carcinoma infiammatorio e tumore localmente avanzato della mammella.…”

“…Although several studies have reported the characteristic signs of IBC [12][13][14][15][16][17][18][19][20], few have specifically investigated its MR imaging patterns [12][13][14][15], and only one recent paper has addressed the MR appearance of IBC and the differential diagnosis with LABC [21]. The purpose of this study was to verify the existence of MR imaging patterns specific to IBC and to evaluate their accuracy in the differential diagnosis between IBC and LABC.…”

The contralateral synchronous breast carcinoma: a comparison of histology, localization, and magnetic resonance imaging characteristics with the primary index cancer

“…Three postinitial curve types were defined [26][27][28]: (1) continuous increase (increase [10%); (2) plateau phenomenon (deviation of the signal curve between ?10% and -10%); (3) wash-out sign (decrease [10%). For the analysis of the MRI morphology, the Breast Imaging Reporting and Data System (BI-RADS) atlas [29] and further morphologic characteristics, in detail described in the literature [27,30,31], were used.…”