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Thomas A, Filimonow S, Slowinski T, Fischer T. [Image quality and characterisation of sonographically detected breast lesions: comparison of tissue harmonic imaging alone and in combination with frequency compounding]. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2007; 28:387-93. [PMID: 17602368 DOI: 10.1055/s-2007-963041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
PURPOSE To determine the accuracy of frequency compounding (FC) in detection and characterisation of breast lesions by ultrasound (US) and to assess the image quality in direct comparison with tissue harmonic imaging (THI). MATERIALS AND METHODS A total of 60 breast lesions were examined; these were malignant in 39 cases and benign in 21 as confirmed by histology of core biopsy specimens (Aplio 80, Toshiba, Otawara, Japan). A total of 120 freeze frames, 60 B-mode scans with THI and 60 scans with FC were assessed by three independent examiners, who determined the presence of pathology on a scale of 1 to 5 using established criteria (BI-RADS classification). Image quality of each technique was rated on a ranking scale of - 2 (FC clearly superior to THI), - 1 (FC slightly superior to THI), 0 (identical), + 1 (THI slightly superior to FC), to + 2 (THI clearly superior to FC). The different US techniques were compared in terms of image quality and diagnostic accuracy using Mann Whitney U test and ROC analysis. RESULTS The results for image quality were as follows: - 0.56 +/- 0.71. In 56 % of the images FC was superior to THI, both techniques were identical in 37 % of cases, and in only 7 % THI was superior to FC. The following AUCs (Area under Curve, presence of pathology) were calculated: 0.945 and 0.969 for THI and FC, respectively (not significant). The two US techniques had comparable sensitivity (FC/THI 100/98 %) and specificity (FC/THI 76/74 %). CONCLUSION Altogether, the diagnostic value of FC was comparable to that of THI with only slight differences. For ultrasound examinations of breast lesions, FC improves the image quality and conspicuity of pathology.
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Akay H, Girgin S, Ozmen CA, Kilic I, Sakarya H. An unusual bilateral mastitis in a postmenopausal woman caused by brucellosis. Acta Chir Belg 2007; 107:320-2. [PMID: 17685262 DOI: 10.1080/00015458.2007.11680065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Breast involvement of brucella can be frequently detected in animals, however, it is extremely rare in humans. Clinical findings and complications may cause difficulties in diagnosis. We report the case of a 52-year old woman with bilateral brucella mastitis, which is difficult to differentiate from inflammatory breast carcinoma.
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Jensenius M, von der Lippe B, Hermansen NO, Jahr G, Caugant DA, Høiby EA, Vene S. Brucellar mastitis: presentation of a case and review of the literature. Int J Infect Dis 2007; 12:98-100. [PMID: 17537662 DOI: 10.1016/j.ijid.2007.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2007] [Accepted: 03/19/2007] [Indexed: 11/19/2022] Open
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Khamapirad T, Hennan K, Leonard M, Eltorky M, Qiu S. Granulomatous lobular mastitis: two case reports with focus on radiologic and histopathologic features. Ann Diagn Pathol 2007; 11:109-12. [PMID: 17349569 DOI: 10.1016/j.anndiagpath.2006.12.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Granulomatous lobular mastitis (GLM) is a rare, benign condition with an unknown etiology that can appear as cancer on mammogram, ultrasound, and magnetic resonance imaging. The terminology of GLM was first named by Going et al (J Clin Pathol 1987;40:535-540) in 1987 after he noted the lobule centered distribution on histologic exam. We present 2 case reports of GLM that clinically and radiographically appeared as malignant lesions. The first case was a 31-year-old woman with a 1-month history of breast mass, and the second case was a 33-year-old woman with a 2-week history of breast mass. Both cases were histologically diagnosed as GLM. Retrospectively, we identified ultrasound and magnetic resonance imaging characteristics that may be used in the future to classify the breast mass before biopsy.
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De Falco M, Parmeggiani U, Oliva G, Piatto A, Allocca A, Accardo M, Calzolari F, Lucchini R, Misso C, Ragusa M, d'Ajello M, Sanguinetti A, Avenia N. [Granulomatous mastitis: diagnostic and therapeutic problems. Case report and review of the literature]. G Chir 2006; 27:422-7. [PMID: 17198551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The granulomatous mastitis is uncommon inflammatory disease of the breast of unknown etiology. The diagnosis is obtained only through hystopathology. We report a case of woman, 41 years old, showing lesions of the breast, that caused strong pain with ulcerations sero-haematic secretion and axillary omolateral lymphadenopathy. The diagnostic workup (sonography, mammography, multiples FNAB of single lesions, the culture of cells and hormonal profile) showed an inflammatory aspecific lesions with presence of atipic cells in nipple's secretion and in FNAB of periareola lesion. We performed an excisional biopsy. The hystopathologic diagnosis showed a granulomatous mastitis, confirming the validity of our diagnostic and therapeutic choices. The excisional biopsy has allowed to avoid an overtreatment and obtain a good aesthetic result.
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Harris SH, Khan MA, Khan R, Haque F, Syed A, Ansari MM. Mammary tuberculosis: analysis of thirty-eight patients. ANZ J Surg 2006; 76:234-7. [PMID: 16681540 DOI: 10.1111/j.1445-2197.2006.03692.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Thirty-eight patients with mammary gland tuberculosis were evaluated over a 5-year period presenting to the surgical unit of our institution. Unilateral involvement of the breast in a woman presenting at an average age of 29 years was the commonest observation. A lump in the breast with or without discharging sinuses was the most common clinical presentation. Ten (26%) of these patients had breast pain with or without increased breast nodularity. Axillary lymph nodal involvement was evident in 14 (36%) of our patients. Only five patients had associated pulmonary tuberculosis, the rest having an isolated involvement of the breast. Fine-needle aspiration cytology was the most reliable diagnostic modality. Medical therapy with antitubercular drugs ranging from 6 to 9 months was the mainstay of treatment. Surgical intervention was reserved for selected refractory cases.
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Sklair-Levy M, Muggia-Sulam M, Mally B. Primary breast tuberculosis diagnosed by sonographically guided core-needle biopsy. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:1357-60. [PMID: 16998113 DOI: 10.7863/jum.2006.25.10.1357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Cerveira I, Costa Matos L, Garrido A, Oliveira E, Solheiro H, Bastos M, Cortez Vaz F, Nogueira Martins F. Lupus mastitis. Breast 2006; 15:670-2. [PMID: 16737816 DOI: 10.1016/j.breast.2006.03.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2005] [Revised: 03/14/2006] [Accepted: 03/16/2006] [Indexed: 11/26/2022] Open
Abstract
We report a case of a 28-year-old female with the diagnosis of systemic lupus erythematosus (SLE) referred to our breast pathology consultancy in 2002 due to a left breast nodule. Further investigation revealed bilateral coarse calcifications. Biopsy was consistent with a diagnosis of lupus mastitis.
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Hmissa S, Sahraoui W, Missaoui N, Stita W, Mokni M, Yacoubi MT, Khairi H, Korbi S. [Lobular idiopathic granulomatos mastitis. About 10 cases]. LA TUNISIE MEDICALE 2006; 84:353-7. [PMID: 17042208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Our retrospective study was performed on 10 cases of granulomatous mastitis registered in Obstetric Gynaecology Department and Pathology Department of CHU F. Hached, Sousse, during 8 years period. The mean age was 36.4 years (range 32-59). Among these 10 cases. 8 were observed in reproductive-age women and 2 were noted in menopausal women. Clinical findings showed unilateral breast nodule associated with inflammatory signs in 4 cases, mammelonary retraction in 2 cases and serous or sero-purulent mamelonnary flow in 4 cases. Mamnmographic examination suggested a malignant tumor in 5 patients. In all cases, the diagnosis is made by histopathology. Surgical treatment consisted in wide excision with drainage or radical mastectomy, eventually with combination with antibiotic therapy and non steroid anti-inflammatory drugs. Prognostic features showed a good cicatrization in 4 cases, local recurrence and cutaneous fistulization in one patient. Granulomatous mastitis aetiology is still unclear, auto-immune aetio-pathogenesis appears more interesting and should be clarified.
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Baer C, Bilkei G. Ultrasonographic and gross pathological findings in the mammary glands of weaned sows having suffered recidiving mastitis metritis agalactia. Reprod Domest Anim 2006; 40:544-7. [PMID: 16324081 DOI: 10.1111/j.1439-0531.2005.00629.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In a large pig breeding herd with high prevalence of post-parturient diseases of the sows, weaned sows of different parity groups with (n = 663) or without (n = 1125) recidiving mastitis metritis agalactia (MMA) in their previous history were subjected to ultrasonography. A total of 114 of 663 sows with recidiving MMA in their previous history and with ultrasonographic visible mammary gland changes, and 157 of sows without recidiving MMA in their previous history were culled and subjected to gross pathological and bacteriological examination of their mammary glands. The sows having suffered MMA had more (p < 0.001) hyperechogenic images in their mammary glands compared with the sow having suffered no recidiving MMA. Abdominal glands were more (p < 0.01) prone to pathological changes compared with the pectoral ones. Sows of high parity had more hyperechogenic images and gross pathological changes in their mammary glands compared with the sows of low parity.
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Bachmeyer C, Goubin I, Berseneff H, Blum L. Coarse Calcifications by Mammography in Lupus Mastitis. ACTA ACUST UNITED AC 2006; 142:398-9. [PMID: 16549728 DOI: 10.1001/archderm.142.3.398] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Gioffrè Florio MA, Famà F, Buccheri G, Di Cara G, Pollicino A, Scarfò P, Gullo G. [Non-lactational mastitis: our experience]. Ann Ital Chir 2006; 77:127-30. [PMID: 17147085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The most frequent breast inflammatory diseases are lactational and non-lactational mastitis. The diagnosis of these lesions is always difficult, as they often mimic breast cancer. The Authors report on their experience about 830 clinical cases of non-lactational mastitis, 804 were superficial abscesses and 24 were phlegmons. In 379 cases an infectious cause was found: in 249 by Streptococcus/Pseudomonas and in 30 by Staphylococcus Aureus. All patients underwent surgical treatment. Diagnosis was obtained by clinical examination, routine investigations (ultrasound, mammography and cytology) and post-operatively by histological evaluation. The non-lactational mastitis are more frequent in the postmenopausal and the menopausal period, but MDAIDS (Mammary Ducts Associated Inflammatory Diseases Sequence) are particularly interesting. MDAIDS was observed in 178 cases, these are very peculiar lesions characterized by ducts ectasia, squamous metaplasia, lymphoid infiltration and strictly correlated with heavy smoking. Sometimes, only surgical treatment clarifies the nature of these lesions. Patients with inflammatory diseases of the breast present with mastalgia and secretions, symptoms which alert patients to consult quickly a specialist. Instrumental investigations often don't clarify the diagnosis and surgical treatment by incision and drainage or excision is definitive.
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Lee JH, Oh KK, Kim EK, Kwack KS, Jung WH, Lee HK. Radiologic and clinical features of idiopathic granulomatous lobular mastitis mimicking advanced breast cancer. Yonsei Med J 2006; 47:78-84. [PMID: 16502488 PMCID: PMC2687584 DOI: 10.3349/ymj.2006.47.1.78] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Idiopathic granulomatous lobular mastitis (IGLM), also known as idiopathic granulomatous mastitis, is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma. The aim of this study was to describe the radiological imaging and clinical features of IGLM in order to better differentiate this disorder from breast cancer. We performed a retrospective analysis of the clinical and radiographic features of 11 women with a total of 12 IGLM lesions. The ages of these women ranged between 29 and 42 years, with a mean age of 34.8 years. Ten patients were examined by both mammography and sonography and one by sonography alone. The sites that were the most frequently involved were the peripheral (6/12), diffuse, (3/12), and subareolar (3/12) regions of the breast. The patient mammograms showed irregular ill-defined masses (7/11), diffuse increased densities (3/11), and one oval obscured mass. In addition, patient sonograms showed irregular tubular lesions (7/12) or lobulated masses with minimal parenchymal distortion (2/12), parenchymal distortion without definite mass lesions (2/12), and one oval mass. Subcutaneous fat obliteration (12/12) and skin thickening (11/12) were also observed in these patients. Contrary to previous reports, skin changes and subareolar involvement were not rare occurrences in IGLM. In conclusion, the sonographic features of IGLM show irregular or tubular hypoechoic masses with minimal parenchymal distortion. Both clinical information and the description of radiographic features of IGLM may aid in the differentiation between IGLM and breast cancer, however histological confirmation is still required for the proper diagnosis and treatment of the disorder.
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Kläber HG, Wieczorek D, Handrick W. [Neonatale mastitis in a 4-week-old infant]. KLINISCHE PADIATRIE 2005; 217:240-3. [PMID: 16032552 DOI: 10.1055/s-2004-832390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This is a case report of a four week old newborn, presenting with a red and swollen right breast gland. Clinical examination and ultrasound confirmed the diagnosis of a suppurative mastitis. The abcess was incised and drained and systemic antibiotic therapy started. Staphylococcus aureus was isolated from the culture. The important aspects of aetiology, pathogenesis, diagnosis and therapy of suppurative mastitis in the newborn are discussed in a short literature review.
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Wang S, Ma HF, Wang XF, Xu B. [Diagnosis of plasma cell mastitis with multi-slice spiral CT]. ACTA ACUST UNITED AC 2005; 3:199-202. [PMID: 15885168 DOI: 10.3736/jcim20050310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of multi-slice spiral CT (MSCT) for plasma cell mastitis. METHODS Radiographs of MSCT for forty-six patients with plasma cell mastitis diagnosed by pathological examination were reviewed. RESULTS The findings of MSCT of plasma cell mastitis could be divided into four types, including the inflammation type, the abscess type, the sinus and fistula type, and the mixed type, and each type had its radiographic characteristics. CONCLUSION MSCT is helpful for diagnosing plasma cell mastitis and should be used as an examination of first choice for the patients.
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Caumo F, Gaioni MB, Bonetti F, Manfrin E, Remo A, Pattaro C. Occult inflammatory breast cancer: review of clinical, mammographic, US and pathologic signs. LA RADIOLOGIA MEDICA 2005; 109:308-20. [PMID: 15883516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
PURPOSE To examine the clinical, radiologic and pathologic findings of occult inflammatory breast cancer (OIBC) in order to identify features useful for diagnosis. MATERIALS AND METHODS We retrospectively reviewed the records of 19 women with OIBC observed at our Department between 1992 and 2001. We analysed the clinical history, mammographic, ultrasonographic, and pathologic findings and investigated overall survival (OS), prognostic variables and radio-pathologic correlations. RESULTS The most common mammographic findings were: diffusely increased density (52.63%), trabecular thickening (42.1%), mass (36.84%). The most common US findings were axillary lymphadenopathy (68.75%), skin thickening (43.75%) and mass (56.25%). At least one inflammatory sign was found in 14 women (74%) at mammography (subcutaneous thickening, trabecular thickening, diffuse increase in density) or at US (subcutaneous thickening, diffuse increase in echogenicity due to oedema, lymph vessel dilatation). Estrogen receptors (ER) were present in 63.2% and Progesterone receptors (PgR) in 36.8%. Significant prognostic variables were ER and Ki 67. CONCLUSIONS The typical radiological pattern of clinical inflammatory breast carcinoma is less frequently present in OIBC; nevertheless the radiologist must pay attention because frequently OIBC presents just one radiological sign and this should be enough for a diagnostic suspicion. Moreover, the absence of clinical and radiological inflammatory signs does not exclude inflammatory breast cancer because OIBC can manifest at imaging as a mass or isolated calcifications. ER and PgR are positive in a high percentage of patients and confirm that OIBC has a better prognosis than clinical inflammatory breast cancer.
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Al-Marri MR, Aref E, Omar AJ. Mammographic features of isolated tuberculous mastitis. Saudi Med J 2005; 26:646-50. [PMID: 15900377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE To present the mammography findings in 8 patients with tuberculosis (TB) of the breast, with a review of the literature. METHODS This study is a retrospective data collection. Each chart with confirmed breast TB based on bacteriology or pathologic findings was analyzed for clinical presentation, gender, nationality, demographic data, prior history of TB, investigation, management, mammographic findings and ultrasound, when available. Mammograms were reviewed by 2 consultant radiologists without knowing the previous diagnosis or the nature of the study. The study was carried out at The State Tuberculosis Registry and Radiology Department, Hamad General Hospital, State of Qatar, from 1990 to 2002. RESULTS Out of 13 females with TB mastitis, only 8 cases had mammograms preoperatively. The incidence of breast TB in Qatar is rare (1/1000 mammograms per year). Three types of TB mastitis were identified in our study; the nodular (50%), the diffuse (37.5%) of which 77% were limited to one sector of the breast and the sclerosing (12.5%) mastitis. Three patients (43%) were reported as carcinoma. CONCLUSION Although mammography identified 3 types of TB, it was not helpful in differentiating TB from carcinoma of the breast. However, the careful evaluation of the degree of density and trabecular thickening of the mass in relation to it size might reduce the number of false positive cases of carcinoma diagnosed with mammograms. Biopsy specimen remains the best diagnostic tool in TB mastitis.
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Tuncbilek N, Karakas HM, Okten OO. Imaging of granulomatous mastitis: assessment of three cases. Breast 2005; 13:510-4. [PMID: 15563860 DOI: 10.1016/j.breast.2004.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2004] [Revised: 06/21/2004] [Accepted: 07/28/2004] [Indexed: 10/26/2022] Open
Abstract
Granulomatous mastitis is a benign, inflammatory breast disease of unknown aetiology, which can mimic breast carcinoma in its clinical manifestations. Imaging features of three cases of granulomatous mastitis mimicking breast carcinoma on both clinical and radiographic examination are presented, with special emphasis on the role of dynamic contrast-enhanced-magnetic resonance mammography in the differential diagnosis.
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Rageth CJ, Ricklin ES, Scholl B, Saurenmann E. [Conservative treatment of puerperal breast abscesses with repeated sonographically guided aspirations and oral antibiotic administrations]. Z Geburtshilfe Neonatol 2004; 208:170-3. [PMID: 15508050 DOI: 10.1055/s-2004-832636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Breast abscesses have usually been treated by incision and drainage. During the past 10 years conservative treatment with repeated ultrasound-guided drainage to evacuate the abscess combined with antibiotic treatment has become a valuable alternative. PATIENTS AND METHODS From 1991 to 2003 the authors treated 17 patients with puerperal abscess with this method. Under local anesthesia with ultrasound guidance a thick needle (preferably a Venflon) is introduced into the cavity. The procedure is repeated every two or three days until the ultrasound image demonstrates a diameter of the cavity of 1.5 cm or less. The oral antibiotic treatment lasts for 6 to 10 days. RESULTS In 7 cases only one puncture was needed, 5 cases needed 2 punctures while 4 women needed 3 or more punctures (up to 5). In 16 cases an open drainage could be avoided. One patient wanted to discontinue the conservative treatment after the first puncture and requested the surgical drainage. CONCLUSIONS Conservative therapy with ultrasound-guided drainage of puerperal breast abscesses can therefore be recommended as a standard treatment.
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Kocaoglu M, Somuncu I, Ors F, Bulakbasi N, Tayfun C, Ilkbahar S. Imaging Findings in Idiopathic Granulomatous Mastitis. J Comput Assist Tomogr 2004; 28:635-41. [PMID: 15480037 DOI: 10.1097/01.rct.0000131927.82761.40] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe magnetic resonance (MR) imaging features of patients with a histologic diagnosis of idiopathic granulomatous mastitis (IGM). METHODS Dynamic contrast-enhanced MR imaging was performed with a 1.5-T MR unit. Postprocessing of images included subtraction and calculation of time-intensity curves of the enhancing regions at several points in all patients. RESULTS In addition to granulomatous inflammation, biopsy slides of 5 patients demonstrated abscess formation without a specific organism (aseptic abscess). One patient had a fibrotic tissue component. Magnetic resonance imaging findings were heterogeneously enhancing areas with (n = 5) and without (n = 1) multiple ring-like enhanced abscesses and a circumscribed lesion with heterogeneous contrast enhancement (n = 1). Time-intensity curves showed a benign pattern in all but 1 patient. CONCLUSION Idiopathic granulomatous mastitis has a number of appearances on MR imaging. Magnetic resonance imaging with measurement of time-signal intensity curves may support the findings of ultrasonography and mammography in distinguishing benign inflammatory breast disorders from malignant ones; however, biopsy still remains the only method of definite diagnosis.
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Sakr AA, Fawzy RK, Fadaly G, Baky MA. Mammographic and sonographic features of tuberculous mastitis. Eur J Radiol 2004; 51:54-60. [PMID: 15186885 DOI: 10.1016/s0720-048x(03)00230-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2002] [Revised: 07/15/2003] [Accepted: 07/21/2003] [Indexed: 11/19/2022]
Abstract
From December 1999 to April 2001, 10 cases of tuberculous mastitis were presented to the Radiology Unit at the Medical Research Institute of Alexandria University for mammographic and sonographic evaluation. Sixty percent presented with masses, 50% mastalgia, 40% discharge, and 10% complained of skin sinus. In 30% of the patients the complaint was bilateral. All cases underwent full mammographic and ultrasonographic (US) studies, and US-guided fine needle aspiration. Also pathological, bacteriological analysis, and polymerase chain reaction (PCR) were done to all patients to prove the tuberculous nature of their lesions. Thirty percent of the cases had surgical excision on their masses. On mammography 30% were found to have mass lesion mimicking malignant tumors, 40% smooth bordered masses, 40% axillary or intramammary adenopathy, 30% asymmetric density, 30% duct ectasia, 20% with skin thickening and nipple retraction, 20% with macrocalcification, and 10% with skin sinus. On US 60% had hypoechoic masses, 40% focal or sectorial duct ectasia, and 50% axillary adenopathy. History of tuberculosis was found in 30% of the cases. Chest X-ray was positive in 20% and breast magnetic resonance imaging was done to one patient who had skin sinus.
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Lell M, Wenkel E, Aichinger U, Schulz-Wendtland R, Bautz W. [3D ultrasound in core breast biopsy]. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2004; 25:126-130. [PMID: 15085454 DOI: 10.1055/s-2004-813103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
AIM To evaluate the potential of three-dimensional ultrasound (3D US) in core biopsy of suspicious breast lesions. METHOD 3D US controlled core biopsy was performed in 107 breast masses in 100 women by using an automated biopsy system (11G coaxial needle, 12 G biopsy needle). Mean diameter of the lesions was 1.55 cm (0.5 - 3.5 cm). A linear 3D US volume scanner was used for the procedure. Localization of the lesion and placement of the needle were initially done under 2D US guidance. After core needle stroke a 3D US volume acquisition was performed to correlate lesion and needle position. In the case of eccentric needle position the needle was repositioned under 3D control. 5 specimens were taken from each lesion. The histological results from the specimens were correlated with the results from surgery or clinical follow-up (> 2.5 years). RESULTS Biopsy was taken from 59 probably benign (BI-RADS 3 - 4) and 48 malignant (BI-RADS 5) lesions. 3D US revealed 61 central, 44 eccentric and 2 marginal needle positions after the initial 2D guidance. Central repositioning of the needle was achievable under 3D guidance in all patients. Histological examination of the specimens revealed 41 invasive carcinomas and one in-situ carcinoma (DCIS). In one lesion, the carcinoma was missed in the core biopsy, despite central hits of the biopsy needle. This led to a sensitivity of 98 %, specificity of 100 %, PPV of 100 %, NPV of 98.5 % and accuracy of 99 % for the diagnosis of a malignant lesion. CONCLUSION 3D US improves needle positioning as well as the depiction of correct needle placement in freehand core biopsy.
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Giron GL, Tartter PI. Image of the month. Silicone mastitis with abscess. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 2004; 139:341-2. [PMID: 15006895 DOI: 10.1001/archsurg.139.3.341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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