MRI of the breast in the differential diagnosis of mastitis versus inflammatory carcinoma and follow-up.

Abstract

Our goal was to evaluate the potential of dynamic MRI in differentiating mastitis and inflammatory breast carcinoma. Furthermore, we evaluated the potential of breast MRI to follow up mastitis patients under antibiotic treatment. Twenty-one cases of dynamic breast MR (11 mastitis, 10 inflammatory carcinomas) were reviewed. All patients had a history consistent with either mastitis or inflammatory breast carcinoma. The final diagnosis was histologically confirmed. Ninety percent of the inflammatory carcinomas were found to enhance > 100% in the first minute compared with 55% for mastitis. There is no significant difference between mastitis and inflammatory carcinoma. While breast MR cannot currently be used definitively to distinguish inflammatory carcinoma from mastitis, the differences in dynamic enhancement may prove to be useful in follow-up of presumed mastitis in problematic cases. If after biopsy the diagnosis remains unclear, breast MR may help to (a) demonstrate the success of the antibiotic treatment and (b) diagnose coexisting or confounding inflammatory carcinoma.