Analysis of Clinically Symptomatic Patients to Differentiate Inflammatory Breast Cancer from Mastitis in Asian Women

To differentiate inflammatory breast cancer (IBC) from mastitis in Asian women presenting with symptoms of inflammation.

Between January 2012 and June 2024, 101 Asian women with symptoms of inflammation underwent breast ultrasound (US). Clinical and demographic data were extracted from patients' medical records. US analysis assessed lesion bilaterality, location, type, size, internal changes, and lymph node status. Patients with suspicious findings had US-guided biopsies, and pathology reports were reviewed for tumor histology and immunohistochemical markers. Logistic regression was used to determine odds ratios.

Of the 101 participants, 14 (13.9%) were diagnosed with IBC and 87 (86.1%) were diagnosed with mastitis. Patients with IBC were significantly older (46.4 vs. 38.4 years, p = 0.020) and showed a higher prevalence of postmenopausal status (57.1% vs. 12.6%, p < 0.0001). These patients experienced a longer symptom onset duration (37.7 vs. 12.7 days, p = 0.002) and more frequent localized symptoms like swelling (50.0% vs. 13.8%, p = 0.004). US findings showed that 21.4% of IBC lesions involved the entire breast, compared to only 1.1% in patients with mastitis (p = 0.001). Biopsy results revealed that invasive ductal carcinoma was the most common malignancy (78.6%). Logistic regression identified symptom onset duration (adjusted odds ratio (OR) 1.07, p = 0.014) and swelling (adjusted OR 15.24, p = 0.016) as significant predictors of IBC.

In Asian women, age, menopausal status, symptom onset duration, and swelling are effective in differentiating IBC from mastitis. Logistic regression confirmed that symptom onset duration and swelling are significant predictors of IBC, with US findings indicating larger lesion sizes and more frequent whole-breast involvement.