Advantages of b-mode ultrasound combined with strain elastography in differentiation of idiopathic granulomatous mastitis from malignant breast lesions

Arslan, Serdar; Öncü, Fatih; Eryılmaz, Mehmet Ali; Durmaz, Mehmet Sedat; Altunkeser, Ayşegül; Ünlü, Yaşar

doi:10.3906/sag-1708-34

Cited by 14 publications

(20 citation statements)

References 25 publications

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“…Investigators are evaluating the value of new techniques in increasing the specificity of ultrasound in diagnosing IGM. In this context, Arslan et al showed that the combination of strain elastography and B-mode ultrasound was superior to B-mode ultrasonography alone in differentiating IGM from malignant breast lesions [21]. Teke et al evaluated the role of acoustic radiation force impulse imaging in differentiating IGM from breast cancer [20].…”

Section: Radiological Investigationsmentioning

confidence: 99%

“…Preoperative diagnosis by TCB have replaced blind surgical excision [11]. Modified breast ultrasound techniques are being tested to improve their diagnostic specificity [20,21]. Evidence is accumulating in favor of using a combination of surgical and immunosuppressive treatment under the care of a multidisciplinary team.…”

Section: Weaknesses and Strengths Of The Studymentioning

confidence: 99%

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The Role of Establishing a Multidisciplinary Team for Idiopathic Granulomatous Mastitis in Improving Patient Outcomes and Spreading Awareness about Recent Disease Trends

Yaghan

Ayoub

Hamouri

et al. 2020

International Journal of Breast Cancer

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Background. Iidiopathic granulomatous mastitis (IGM) is stereotypically described as a mysterious entity that mimics breast carcinoma imposing management challenges. In 2002, we established a multidisciplinary team to treat patients with IGM. This study aimed to evaluate the role of this team in improving patient outcomes. Also, a review of literature is provided to highlight recent disease trends. Patients and Methods. Pertinent data for 44 patients treated for IGM from 2002 to 2018 were analyzed and compared to data prior to 2002. Results. Mean age at diagnosis was 37.9 years ± 6.4. The diagnosis of IGM was confirmed by True-cut biopsy (TCB), Frozen section (FS), and surgical biopsy in 70.5%, 25%, and 4.5% of patients, respectively. FS was used to assess the resection margins in three patients. Suspicion for malignancy was raised in one out of 39 ultrasound reports, and one out of 20 mammography reports. Wide local excision was the main treatment modality (95.5%). 19 patients (43.2%) received corticosteroids. Prior to 2002, IGM was only recognized after surgical resection with a 71% initial false impression of carcinoma. After 2002, the initial false clinical impression of carcinoma dropped to 29.5%. Recurrence rate was 31.82%. Younger age at diagnosis was significantly associated with recurrence (χ2 = 5.598; p=0.018). Chi-square analysis showed no significant association between BMI and recurrence (χ2 = 0.776; p=0.678). Conclusion. The establishment of a multidisciplinary team for IGM was associated with a reduced erroneous impression of breast cancer, and a reduced false positive radiological diagnosis of breast carcinoma. FS was a useful confirmatory procedure. Our series included the first case of a diffuse papular rash as a systemic manifestation of IGM. Recent literature indicates that IGM is changing its face. IGM is being reported in all age groups, and even in males. The clinical manifestations have markedly expanded. Diagnosis by TCB has replaced blind surgical excision. More data regarding predictors of recurrence is accumulating.

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Section: Radiological Investigationsmentioning

confidence: 99%

Section: Weaknesses and Strengths Of The Studymentioning

confidence: 99%

The Role of Establishing a Multidisciplinary Team for Idiopathic Granulomatous Mastitis in Improving Patient Outcomes and Spreading Awareness about Recent Disease Trends

Yaghan

Ayoub

Hamouri

et al. 2020

International Journal of Breast Cancer

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“…Los hallazgos varían, es más frecuente una gran masa hipoecoica heterogénea irregular (53,33%) con múltiples extensiones tubulares, la mayoría de veces en eje paralelo a la piel; también se puede observar masas lobuladas o irregulares y/o masa circunscrita hipoecoica (26,6%) 1,16,17 . Se han descrito el refuerzo acústico posterior y sombra acústica posterior 1 .…”

Section: Discussionunclassified

“…En general, la resonancia magnética del seno tiene una alta sensibilidad (91-100%) en la detección de lesiones malignas. Está indicada cuando la evaluación con mamografía y ecografía son limitadas por edema parenquimatoso o densidad mamaria 10,17 .…”

Section: Discussionunclassified

Mastitis granulomatosa: un reto radiológico

Manrique¹,

Botero²,

Vera³

et al. 2023

RCHRAD

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Introducción: La mastitis granulomatosa es una enfermedad inflamatoria crónica benigna de etiología desconocida y buen pronóstico, sin embargo, es una entidad de difícil diagnóstico debido a sus hallazgos inespecíficos y variabilidad en los diagnósticos diferenciales. Objetivo: Brindar herramientas útiles en el diagnóstico oportuno de mastitis granulomatosa con sus principales hallazgos imagenológicos. Materiales y métodos: Se realizó un análisis retrospectivo de los hallazgos imagenológicos en 17 mujeres con diagnóstico histopatológico de mastitis granulomatosa entre enero del 2017 y marzo del 2019 con una revisión bibliográfica del tema. Resultados: De 17 pacientes con resultado histopatológico de mastitis granulomatosa, 15 fueron valoradas inicialmente con ultrasonografía, encontrando que el 53,3% presentaron masa heterogénea hipoecoica, seguido de extensiones tubulares en un 46,6%, además un 26,6% presentó masa circunscrita, colección y adenopatías axilares hallazgos acordes con la literatura mundial. Solo a una paciente se le realizó mamografía, en la cual se encontró una asimetría focal de la densidad del tejido mamario siendo el hallazgo más frecuente. Se realizó a una paciente resonancia magnética con realce no masa y fístula cutánea como complicación, que equivale al 6,6%. Conclusión: Nuestros hallazgos imagenológicos son concordantes con la literatura mundial y se logró identificar las características radiológicas centrados principalmente en ultrasonido.

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“…Arslan et al [31] reported that IGM was categorized BIRADS III on B-Mode USG based on its characteristics of irregular heterogeneously hypoechoic mass with tubular extensions. However, IGM appeared soft on SE with elasticity score of 2 and lower SR.…”

Section: Gupta Et Almentioning

confidence: 99%

A Pilot Study for Evaluation of Role of B-Mode Ultrasound and Strain Elastography in Differentiating Benign and Malignant Breast Masses

Gupta

Kaur

et al. 2021

Asian J Pharm Clin Res

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Background: Early detection of malignant lesions is critical key stone for the successful management of breast cancer. Conventional B-mode ultrasound although could not replace the histopathology which is still gold standard, plays an important role in the diagnostic pathways by using the Breast Imaging Reporting and Data System (BIRADS) lexicon (standardized by American College of Radiology [ACR]). Although characterization of solid breast masses by sonography has improved greatly since the early 1990s, specificity remains low and a large number of biopsies result in benign diagnosis. Strain elastography and strain ratio (SR) are recent techniques which may help in increasing the specificity of ultrasound. Methods: The present study was a pilot study aimed to establish a correlation between B-mode ultrasound and strain elastography in differentiating benign and malignant breast masses and to compare the results of B- mode ultrasound and Strain Elastography with fine-needle aspiration cytology/ biopsy findings. It was a prospective study conducted in the Department of Radio-diagnosis of Rajindra Hospital, Patiala. A total of 40 patients who presented with the complaint of palpable breast lump were evaluated with B-Mode Ultrasonography (USG) and Strain elastography (using elastography score [ES] and SR). Results: The study group (40 patients with breast lumps) comprised 38 (95%) female patients and 2 (5%) male patients. Among the group 29 were benign and 11 were malignant. Fibroadenoma followed by fibrocystic disease was the most common benign pathologies and invasive ductal carcinoma followed by Ductal Carcinoma in situ was the most common malignant pathologies. Sensitivity, specificity, and diagnostic accuracy of B-Mode USG in diagnosing palpable breast lump are 72.7%, 86.2%, and 82.5%, respectively, while that of strain elastography in diagnosing palpable breast lump are 81.8%, 93.10%, and 90.0%, respectively. Using strain ratio (SR) only the sensitivity, specificity, and diagnostic accuracy was found to be 93.1%, 100%, and 95% better than B-Mode USG and shear elastography alone separately and combined. The mean SR for a benign mass is 2.00±0.97 and for a malignant mass is 5.40±1.55. Conclusion: Ultrasound elastography (using ES) has a higher sensitivity, specificity and diagnostic accuracy in differentiating benign and malignant breast masses then B mode USG (using BIRADS). Using SR alone has shown better sensitivity, specificity, and diagnostic accuracy but its standalone or in combination diagnostic application has to be followed up with further studies.

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Advantages of b-mode ultrasound combined with strain elastography in differentiation of idiopathic granulomatous mastitis from malignant breast lesions

Cited by 14 publications

References 25 publications

The Role of Establishing a Multidisciplinary Team for Idiopathic Granulomatous Mastitis in Improving Patient Outcomes and Spreading Awareness about Recent Disease Trends

The Role of Establishing a Multidisciplinary Team for Idiopathic Granulomatous Mastitis in Improving Patient Outcomes and Spreading Awareness about Recent Disease Trends

Mastitis granulomatosa: un reto radiológico

A Pilot Study for Evaluation of Role of B-Mode Ultrasound and Strain Elastography in Differentiating Benign and Malignant Breast Masses

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