Learning objectives
1. To recognize the category of inflammatory breast disease and to compare these diseases with inflammatory breast cancer2. To review the radiologic findings and clinical manifestation of inflammatory breast disease3. To introduce US-guided treatment of breast abscess
Background
Introduction of inflammatory breast disease and review of radiologic findings and clinical manifestation with practical example of mammography andultrasound. Categorization of inflammatory breast disease and differential diagnosis from the inflammatory breast cancerIntroduction of US-guided abscess treatment and comparision with traditional surgical treatment
Imaging findings OR Procedure details
I. Pyogenic mastitis and abscess
Clinical manifestation: pain and erythema
Radiologic findings
Mammography: not useful (US: ideal imaging)
Mastitis: diffuse or focal skin and trabecular thickening from breast edemaAbscess: Ill-defined noncalcified mass
US findings of mastitis
Decreased parenchymal echogenicity or increased fat echogenicitySkin thickeningIncreased vascularity on color DopplerReactive or enlarged axillary LNsDilated lymphatics.
US findings of breast abscess
Round, oval, or irregular hypoechoic lesion (homogeneous or inhomogeneous) Irregular hypoechoic or anechoic massesSometimes with fluid/debris levelsUsually with posterior acoustic enhancement
II. US-guided treatment of breast abscess...
Conclusion
Radiologists should be knowledgeable in imaging findings in each category of inflammatory breast disease.In the evaluation of inflammatory breast disease, radiologist should keep in mind the possibility of breast cancer.In breast abscess, US-guided treatment can be alternative to traditional surgical treatment.
References
D Ulitzsch, M.Nyman, R.A.Carlson Breast Abscess in Lactating Women: US-guided Treatment. Radiology 2004; 232:904-909E.Yilmaz, B.Lebe, C.Usal, P.Balci Mammographic and sonographic findings in the diagnosis of idiopathic granulomatous mastitis. Eur.Radiol. 2001; 11:2236-2240K.K.Oh, J.H.Kim, S.H.Kook Imaging of tuberculosis disease involving breast. Eur.Radiol. 8,1475-1480(1998)S.Y.Chung, K.S.Park, Y.Lee, C.K.Park: Breast Sparganosis: mammographic and Ultrasound Features. J Clin Ultrasound 23:447-451, September 1995