Assessment of imaging findings in inflammatory breast disease by ultrasound

Abstract

Inflammatory breast disorders include a wide array of underlying causes, ranging from common benign infection, noninfectious inflammation and inflammation resulting from underlying breast malignancy. Mastitis refers to inflammation of the breast parenchyma, often presenting with pain, heat and redness that may be a debilitating illness with prolonged morbidity. It may also present with a wide array of other nonspecific symptoms, which may lead to delayed diagnosis and inappropriate treatment. Because it is at times difficult to distinguish mastitis and breast cancer based on clinical features, awareness of detailed imaging features is crucial for better management of inflammatory breast disorders using selected cases with mammography, ultrasound and magnetic resonance images. Failure to respond to antibiotic therapy is usually an indication for a biopsy to rule out underlying malignancy. The breast is a superficial organ and often inflammation would involve the overlying skin. Features of cellulitis such as skin thickening and subcutaneous edema should be noted. Radiological imaging is more advantageous than clinical examination in evaluating skin thickening as it allows accurate delineation of its extent, measurement and comparison to surrounding skin and contralateral breast. Broadly, inflammatory disorders of the breast can be divided into three categories: infectious mastitis, non-infectious mastitis and mastitis related to underlying malignancy.