Breast Ultrasound and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Findings of Idiopathic Granulomatous Mastitis: A Retrospective Single-Center Clinical Study

• Published in: Hamidiye Medical Journal Vol. 5; no. 2; pp. 97 - 105
• Main Authors: Taşçı, Filiz, Metin, Yavuz, Orhan Metin, Nurgül, Gözükara, Melih Gaffar, Taşçı, Erencan
• Format: Journal Article
• Language: English
• Published: Sağlık Bilimleri Üniversitesi, Hamidiye Tıp Fakültesi 28.06.2024
• Subjects: Sağlık Hizmetleri; Tıp; İstanbul; Türkiye; magnetic resonance imaging; meme; ultrasonography; ultrasonografi; manyetik rezonans görüntüleme; breast; Idiopathic granulomatous mastitis; İdiyopatik granülomatöz mastit
• ISSN: 2718-0956; 2718-0956
• DOI: 10.4274/hamidiyemedj.galenos.2024.72692

Background: We aimed to evaluate the effectiveness of breast ultrasound (US) and dynamic contrast-enhanced magnetic resonance imaging (DC-MRI) in the diagnosis of idiopathic granulomatous mastitis (IGM). Materials and Methods: Breast US and DC-MRI findings of 42 female patients diagnosed with IGM histopathologically were retrospectively evaluated. Patient’s age, pregnancy history, symptoms, prolactin level, and Breast Imaging-Reporting and Data System (BI-RADS) category of breast lesions were recorded. Results: The median age of patients was 39 years (range, 20-71 years, 76.2% were under 40 years of age). Pregnancy history, elevated serum prolactin levels, and complaints (breast pain, swelling, or rash) were evident in 40.5%, 23.8%, and 95.2% of the patients, respectively. Breast lesions were mostly categorized as BI-RADS category 3 (38.1%) or BI-RADS category 4A (40.5%). The most common additional findings detected in both imaging modalities were edema (95.2%; 90.5%), reactive lymph nodes (95.2% each), and skin thickening (90.5%; 52.4%). The most common findings specific to US are lesions with irregular borders (88.1%) and hypo-heterogenic echo pattern (92.9%); tubular expansion and connecting tracts (88.1%), cystic component (69.0%), floating debris (64.3%), and ductal ectasia (52.4%). The most common findings specific to DC-MRI are; localized collective abscess (57.5%) and micro-abscess (53.7%), minimal background parenchymal enhancement (66.6%), non-mass enhancement with heterogeneous (48.3%) or cluster (44.8%) internal pattern, and regional distribution (44.8%). Median values for abscess size, lymph node short axis, and apparent diffusion coefficient were 25 mm, 10 mm, and (1.064x10-3 mm2/s), respectively, while the mean lymph node long axis was 18.0 mm. Conclusion: Some findings detected on US (heterogeneous hypoechoic lesions, tubular expansion and connection paths, cystic component, floating debris and ductal ectasia) and breast MRI (regionally distributed heterogeneous or clustered internal pattern, non-mass contrast enhancement and minimal background staining, localized collective abscess or microabscess) largely support the diagnosis of IGM.