Value of ultrasonography in differential diagnosis of granulomatous lobular mastitis and breast cancer

Abstract

Objective To investigate the value of color Doppler ultrasonography in differential diagnosis of granulomatous lobular mastitis (GLM) and breast cancer. Methods Preoperative sonograms of 45 GLM, 115 invasive ductal carcinoma (IDC) and 90 ductal carcinoma in situ (DCIS) patients were retrospectively analyzed and further confirmed by histopathology. Results The average age of patients in GLM group was obviously younger than those in IDC and DCIS groups(P<0.001). The size of mass lesion in GLM group was significantly larger than those in IDC and DCIS groups(P<0.001). Compared to IDC group, GLM group showed higher detection rate of liquidity area and mammary ductal ectasia (P<0.01), while less lesions with irregular shape, large A/T ratios (≥0.7), calcification, spiculate margin, peripheral hyperechoic zone or posterior echo attenuation (P<0.05). There were more lesions with spiculate margin, liquidity area or axillary lymph node enlargement found in GLM group than in DCIS group (P<0.01), but less calcification (P<0.001). The accordance rate of ultrasonic diagnosis and postoperative histopathology results in 45 GLM patients was 33.3%(15/45). Conclusions GLM shows the characteristic sonographic findings. In addition, there are some differences between GLM and both IDC & DCIS, such as spiculate margin, peripheral hyperechoic zone, blood flow richness and axillary lymph node enlargement. Combined with the clinical data, understanding the sonographic features of GLM is beneficial to its differential diagnosis with breast cancer. Key words: Ultrasonography; Granulomatous mastitis; Diagnosis, differential