Radiological mammographic and sonographic features of idiopathic granulomatous mastitis

Idiopathic granulomatous mastitis [IGM] is a rare disease of the breast that can clinically and radiologically mimic cancer and result in unnecessary mastectomies. To describe the radiological mammographic and ultrasonographic features of IGM, and to correlate the imaging appearances and histopathological diagnoses. A retrospective study. Radiology Department, King Hussein Medical Centre, Amman, Jordan. The study was conducted between January 1st 2002 and December 31st 2007. Mammograms and breast ultrasounds of 13 symptomatic female patients with histopathologically proven diagnoses of IGM were reviewed. All the patients underwent fine-needle aspiration and excisional biopsy. The radiological features and histopathological diagnoses were compared. Mammography showed focal asymmetrical densities with no distinct margins in 7 patients; ill-defined masses with speculated margins in 3; large focal asymmetrical densities with small well defined mass in 2, and a large diffuse opacity involving the entire dense breast in 1. Breast ultrasound showed tubular hypoechoic lesions in 7 patients; irregular hypoechoic mass with tubular connections in 3; decreased parenchymal echogenicity and acoustic shadowing at the site of the palpable mass in 2, and no abnormality in 1. Radiological mammographic and sonographic features could suggest the possibility of IGM, and may aid in the differentiation between IGM and breast cancer. However, a histological confirmation is still required for the proper diagnosis and determination of an appropriate treatment

Radiologic and Clinical Features of Idiopathic Granulomatous Lobular Mastitis Mimicking Advanced Breast Cancer

Idiopathic granulomatous lobular mastitis (IGLM), also known as idiopathic granulomatous mastitis, is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The aim of this study was to describe the radiological imaging and clinical features of IGLM in order to better differentiate this disorder from breast cancer. We performed a retrospective analysis of the clinical and radiographic features of 11 women with a total of 12 IGLM lesions. The ages of these women ranged between 29 and 42 years, with a mean age of 34.8 years. Ten patients were examined by both mammography and sonography and one by sonography alone. The sites that were the most frequently involved were the peripheral (6/12), diffuse, (3/12), and subareolar (3/12) regions of the breast. The patient mammograms showed irregular ill-defined masses (7/11), diffuse increased densities (3/11), and one oval obscured mass. In addition, patient sonograms showed irregular tubular lesions (7/12) or lobulated masses with minimal parenchymal distortion (2/12), parenchymal distortion without definite mass lesions (2/12), and one oval mass. Subcutaneous fat obliteration (12/12) and skin thickening (11/12) were also observed in these patients. Contrary to previous reports, skin changes and subareolar involvement were not rare occurrences in IGLM. In conclusion, the sonographic features of IGLM show irregular or tubular hypoechoic masses with minimal parenchymal distortion. Both clinical information and the description of radiographic features of IGLM may aid in the differentiation between IGLM and breast cancer, however histological confirmation is still required for the proper diagnosis and treatment of the disorder.