MRI of the Breast in the Differential Diagnosis of Mastitis Versus Inflammatory Carcinoma and Follow-Up

Rieber, A.; Tomczak, R; Mergo, Patricia J.; Wenzel, Volker; Zeitler, H.; Brambs, Hans-Juergen

doi:10.1097/00004728-199701000-00025

Cited by 58 publications

(48 citation statements)

References 11 publications

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“…Unfortunately, these findings were non-specific and similar to findings for carcinoma. MRI features of non-puerperal mastitis described in the published literature are scarce [7,13,14]. These reports state that non-puerperal mastitis has a wide spectrum of appearances, such as a ring-like enhancement, intensively enhancing irregular mass and focal homogeneous enhancing masses, which are all consistent with our findings.…”

Section: Discussionsupporting

confidence: 91%

“…Lesions were mammographically undetectable in 6 of 25 females, possibly because of an overlying dense mammary gland pattern observed in most females. With mammography, two patients in our study showed nipple retraction, and one showed skin thickening in the mammary areola, which is more commonly observed in inflammatory breast carcinoma or invasive carcinoma [7][8][9]. The ultrasound manifestations of non-puerperal mastitis varied.…”

Section: Discussionmentioning

confidence: 65%

“…This is different from our findings in non-puerperal mastitis. However, Rieber et al [7] revealed that breast MR cannot definitively distinguish inflammatory carcinoma from mastitis. Thus, further contrast studies between non-puerperal mastitis and inflammatory breast cancer are required.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of patients with non-puerperal mastitis usually exhibit one or several breast masses without any other signs of inflammation. Because it can be very difficult to distinguish these symptoms from breast carcinoma, these patients can easily be misdiagnosed as having an inflammatory breast carcinoma or an invasive carcinoma [7][8][9].…”

Section: Advances In Knowledgementioning

confidence: 99%

“…However, the appearance of nonpuerperal mastitis on mammography and sonography is non-specific [5,[10][11][12][13]. MR mammography is useful for the detection of non-puerperal mastitis, but the published literature on using MRI to detect nonpuerperal mastitis is sparse [7,13,14]. The purpose of this study is to assess and describe the clinical features and image findings of adult non-puerperal mastitis on mammograms, sonograms and MRI as well as to discover the best method for accurately determining the disease.…”

Section: Advances In Knowledgementioning

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: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Advances In Knowledgementioning

confidence: 99%

Section: Advances In Knowledgementioning

confidence: 99%

See 3 more Smart Citations

Radiological and clinical features of adult non-puerperal mastitis

Tan¹,

Li²,

Peng³

et al. 2013

BJR

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MRI of Breast Lesions

Kaiser

2001

CP Magnetic Resonance Imaging

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In Magnetic Resonance Mammography (MRM) high spatial as well as temporal resolution is of utmost importance for differentiating between malignant and benign lesions. Therefore, a so‐called dynamic technique (i.e., the repetitive imaging of the same slices before and in short time intervals after the injection of contrast medium) is essential to detect the differences in initial enhancements between malignant and benign lesions which are reflected by the tumorangiogenetic vascular network of malignant lesions. This unit presents a basic protocol and several alternate protocols for dynamic MRM.

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Morphological manifestations of nonpuerperal mastitis on magnetic resonance imaging

Liu

Peng

2011

Magnetic Resonance Imaging

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Purpose: To investigate the morphological features of nonpuerperal mastitis on magnetic resonance imaging (MRI). Materials and Methods:MRI results of 27 patients diagnosed with nonpuerperal mastitis were retrospectively analyzed according to the Breast Imaging Reporting and Data System (BI-RADS).Results: According to the enhanced MRI results, 22 cases presented as nonmass-like enhancements and five cases presented as masses. For the 22 nonmass-like enhancement lesions, one case showed as a homogeneous enhancement and 21 cases showed as heterogeneous enhancements. In the 21 heterogeneous enhancement cases, 13 contained lesions of rim-like enhancement. With regard to the number of lesions with rim-like enhancement, 11 presented as multiple and two as single. In the five mass lesions, three presented as rim enhancements. Indications of rim or rim-like enhancement accounted for 59% (16/27) of all cases. For the 16 cases that presented with signs of rim or rim-like enhancement, the central hypointensity area surrounded by enhanced rim or rim-like entity showed as hyperintensity in 14 cases and hypointensity or heterointensity in two cases on T2-weighted imaging.Conclusion: On contrast-enhanced MRI, most nonpuerperal mastitis presented as nonmass-like lesion with heterogeneous signal intensity. The observation of signs of rim or rim-like enhancement on contrast-enhanced MRI with central hypointensity areas showing as hyperintensity on T2-weighted imaging is suggestive of the possibility of nonpuerperal mastitis. MASTITIS MOST COMMONLY OCCURS in lactating females when bacteria enter through cracks in the nipples (1). Nonpuerperal mastitis is a heterogeneous entity and includes a wide spectrum of disorders such as newborn mastitis, thelitis, bacterial infection of the milk ducts with subsequent abscess or fistula formation, and plasma cell mastitis or granulomatous mastitis, which are nonbacterial infections that generally originate from deeper milk ducts (2). Currently, the rate of benign inflammation in nonlactating breasts is increasing (3). Mammographically, nonpuerperal mastitis often presents with nonspecific imaging features as a focal or diffuse asymmetric density (4,5). Sonographically, it can manifest as a hypoechoic mass (4,5), cyst, or abscess (1,6).Magnetic resonance mammography (MRM) is a wellestablished method to diagnose invasive breast carcinoma and breast carcinoma in situ (7,8). Despite the use of MRM for diagnosis, limited data exist on the characteristics of inflammatory breast diseases on MRM (9). Sporadic reports indicated that breast inflammation might present as mass or nonmass-like enhancement with different distributions and internal enhancement patterns on enhanced MRM, which makes the identification of the disease difficult on MRM. The purpose of this study was to elucidate and define the appearance of nonpuerperal mastitis using a sample of 27 patients. MATERIALS AND METHODS Patient SelectionFrom July 2007 to January 2010, 27 patients diagnosed with mastitis underwent contrast materialenhan...

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MRI of the Breast in the Differential Diagnosis of Mastitis Versus Inflammatory Carcinoma and Follow-Up

Cited by 58 publications

References 11 publications

Radiological and clinical features of adult non-puerperal mastitis

Radiological and clinical features of adult non-puerperal mastitis

MRI of Breast Lesions

Morphological manifestations of nonpuerperal mastitis on magnetic resonance imaging

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