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Granulomatous mastitis: changing clinical and imaging features with image-guided biopsy correlation
Priyanka Handa1, A Jill Leibman, Derek Sun
1Department of Radiology, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY, 10461, USA, Handa.priyanka@gmail.com.
European Radiology
|June 26, 2014
Summary
Granulomatous mastitis can affect postmenopausal or asymptomatic individuals, presenting with varied imaging findings. Image-guided biopsy is the optimal diagnostic method, reserving surgical excision for treatment.
Area of Science:
- Radiology
- Pathology
- Oncology
Background:
- Granulomatous mastitis (GM) is a rare, chronic inflammatory breast disease.
- Traditionally, GM has been associated with young, premenopausal women with palpable symptoms.
Purpose of the Study:
- To review the clinical presentation, patient demographics, and imaging findings of granulomatous mastitis.
- To determine the optimal biopsy method for diagnosing GM.
Main Methods:
- Retrospective study of 27 patients with pathology-proven granulomatous mastitis.
- Review of clinical presentation, imaging (mammography, ultrasound), and biopsy methods.
Main Results:
- Average age at presentation was 38 years (range 21-73).
- 19 patients had mammography findings, often mammographically occult lesions.
- Ultrasound revealed mass lesions as the most common finding.
- Image-guided biopsy achieved pathological diagnosis in 44% of patients.
Conclusions:
- Granulomatous mastitis can occur in postmenopausal or asymptomatic patients, challenging previous assumptions.
- Mammographic presentation as calcifications, requiring image-guided vacuum-assisted biopsy, is a novel finding.
- Image-guided biopsy is effective for diagnosis; surgical excision is for definitive treatment.
