Imaging benign inflammatory syndromes

Ferrón, S.; Asad-Syed, M.; Boisserie-Lacroix, M.; Palussière, Jean; Hurtevent, G.

doi:10.1016/j.diii.2011.12.002

Cited by 16 publications

(9 citation statements)

References 19 publications

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“…Many studies have shown that most cases of mastitis show a persistent or plateau pattern, which helps to differentiate the condition from malignant lesions [11] , [12] , [20] . In our study, breast cancer showed a washout pattern more frequently than inflammatory breast diseases.…”

Section: Discussionmentioning

confidence: 99%

A Rim-Enhanced Mass with Central Cystic Changes on MR Imaging: How to Distinguish Breast Cancer from Inflammatory Breast Diseases?

Wang

Fei

et al. 2014

PLoS ONE

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ObjectiveTo evaluate the capacity of magnetic resonance imaging (MRI) to distinguish breast cancer from inflammatory breast diseases manifesting as a rim-enhanced mass with central cystic changes.Materials and MethodsForty cases of breast cancer and 52 of inflammatory breast diseases showing a rim-enhanced mass with central cystic changes were retrospectively reviewed. All cases underwent dynamic contrast-enhanced MRI and 31 of them underwent diffusion-weighted imaging (DWI). Morphological features, dynamic parameters and apparent diffusion coefficient (ADC) values were comparatively analyzed using univariate analysis and binary logistic regression analysis.ResultsBreast cancer had a significantly thicker wall than the inflammatory breast diseases (P<0.001) while internal enhancing septa were more common in inflammatory breast diseases (P = 0.003). On DWI, 86.7% of breast cancers demonstrate a peripheral hyperintensity whereas 93.8% of inflammatory breast diseases had a central hyperintensity (P<0.001). Compared to the inflammatory breast diseases, breast cancers had a lower ADC value for the wall (1.09×10−3 mm2/s vs 1.42×10−3 mm2/s, P<0.001) and a higher ADC value for the central part (1.94×10−3 mm2/s vs 1.05×10−3 mm2/s, P<0.001).ConclusionsBoth breast cancer and inflammatory breast diseases could present as a rim-enhanced mass with central cystic changes on MRI. Integrated analysis of the MR findings can allow for an accurate differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

A Rim-Enhanced Mass with Central Cystic Changes on MR Imaging: How to Distinguish Breast Cancer from Inflammatory Breast Diseases?

Wang

Fei

et al. 2014

PLoS ONE

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“…Inflammatory breast, sometimes referred to as red breast syndrome, is a classic but rare complaint in women consulting at gynecology emergency centers [ 1 , 2 ]. It usually presents as a red and hot breast and is often associated with breast pain [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Incidence of inflammatory breast cancer in patients with clinical inflammatory breast symptoms

et al. 2017

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BackgroundTo describe a large cohort of women with non-puerperal inflammatory breast and to identify characteristics of inflammatory breast cancer.MethodsAll patients consulting for inflammatory breast syndrome in the breast unit of our tertiary University hospital between September 2013 and December 2015 were prospectively included. We excluded women who were pregnant or in the postpartum period. Patients underwent systematic clinical examination and imaging (breast ultrasonography and mammography). A biopsy was performed if the clinician suspected a malignant lesion of the breast. Clinicopathologic and radiologic data were registered. Statistics were performed using R (3.0.2 version) software.ResultsAmong the 76 patients screened and included, 38 (50%) had a malignant lesion at final diagnosis, 21 (27.6%) were diagnosed with infectious disease and 17 (22.4%) with inflammatory disease of the breast. When compared to patients with benign disease, patients with a malignant lesion were significantly older (p = 0.022, CI95% 1.78–14.7), had a significantly bigger palpable mass (p<0.001, CI 95% 22.8–58.9), were more likely to have skin thickening (p = 0.05) and had more suspicious lymph nodes at clinical examination (p<0.001, CI 95% 2.72–65.3). Precise limits on ultrasonography were significantly associated with benign lesions. The presence of a mass (p = 0.04), micro calcifications (p = 0.04) or of focal asymmetry (p<0.001, CI95% 1.3–618) on mammography was significantly associated with malignant disease.ConclusionInflammatory breast cancer was common in our cohort of women consulting for inflammatory breast syndrome. Identifying these patients with high-risk malignancy is crucial in the management of an inflammatory breast.

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“…Advanced mastitis collections may present as round masses on ultrasound with surrounding hypervascularity. 29 Current guidelines recommend oral antibiotic treatment with continued breastfeeding to decrease engorgement. 30 Empiric treatment of S. aureus mastitis is usually with dicloxacillin or erythromycin in patients with penicillin allergies.…”

Section: Case #6: Mastitismentioning

confidence: 99%

“…Most commonly, it is caused by S. aureus but may also involve methicillin-resistant S. aureus and anaerobic organisms. 29 Clinical management of uncomplicated mastitis includes empiric antibiotic therapy, but unresolving infections even under antibiotic treatment warrants ultrasound diagnosis. Ultrasound examination of the affected breast is an appropriate initial imaging tool to look for possibilities of breast abscess or inflammatory breast disease which may have similar clinical presentations as mastitis.…”

Section: Case #6: Mastitismentioning

confidence: 99%

Ultrasound Assessment of Postpartum Fever

Tie¹,

Tajnert²,

O’Neill³

2013

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Postpartum fever and infection remain a significant cause of morbidity in postpartum period. Ultrasound is useful for assessment of the patients who present with temperature elevation, vaginal bleeding, pelvic and/or abdominal pain and signs of infection. Sonography can also be used to detect mastitis and breast abscess. Different types of imaging may be used in patients with refractory fever from suspected pyelonephritis, renal abscess and deep vein thrombosis. This article presents a variety of case scenarios regarding the postpartum fever. By using illustrative images the learner will be able to differentiate between the most common causes of postpartum fever, and will be able to identify typical B-mode, color Doppler, and CT images that require immediate antibiotic and/or invasive treatment.

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Imaging benign inflammatory syndromes

Cited by 16 publications

References 19 publications

A Rim-Enhanced Mass with Central Cystic Changes on MR Imaging: How to Distinguish Breast Cancer from Inflammatory Breast Diseases?

A Rim-Enhanced Mass with Central Cystic Changes on MR Imaging: How to Distinguish Breast Cancer from Inflammatory Breast Diseases?

Incidence of inflammatory breast cancer in patients with clinical inflammatory breast symptoms

Ultrasound Assessment of Postpartum Fever

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