Radiological review of ten cases of granulomatous mastitis of the breast

Abstract

Purpose Granulomatous mastitis of the breast is a rare entity that can mimic breast carcinoma. It can be linked with tuberculosis (TB) or be idiopathic. There is often discrepancy between the clinical signs, the mammo or ultrasound (US) appearances and the histology result. This may result in multiple biopsies and difficult explanations to anxious patients. The aim of this review was to determine whether a specific radiological appearance can be identified which, in conjunction with the benign histology, might provide reassurance in cases of radio-clinical discrepancy and avoid the need for multiple biopsies. Methods and materials All cases of granulomatous mastitis diagnosed between 2012 and 2014 were reviewed; the clinical and radiological presentations were correlated with the histology. The outcomes and treatment of the patients were also documented. Results Ten patients presented with a palpable lump graded P2-P5. Two different radiological patterns were identified: five patients had features of non-specific inflammatory changes in mammo and/or US (M2-3, US 2-3), five patients had a U4 US with non-specific asymmetric density (ASD) in mammography. Two patients had two biopsies, one patient had three biopsies. No malignancy was identified. Conclusion Despite an initial clinical presentation that can mimic a carcinoma, the association of non-specific mammo findings, U3 or U4 US findings and granulomatous mastitis at the initial biopsy should be enough to prove the lack of malignancy