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Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
Breast MRI features of idiopathic granulomatous mastitis and invasive breast carcinoma: A single-center comparative
Nigar Erkoc1, Elif Hazal Karlı1, Merve Tokoçin2
1Department of Radiology, Bagcilar Training and Research Hospital-Istanbul, Turkey.
Objective:
To compare magnetic resonance imaging (MRI) features of idiopathic granulomatous mastitis (IGM) and invasive breast carcinoma (IBC) and to identify imaging criteria for their differentiation.
Methods:
This retrospective study included 301 women with histopathologically confirmed IGM (n = 121) or IBC (n = 180) who underwent breast MRI between January 2019 and February 2024. MRI evaluation followed the 5th edition BI-RADS MRI lexicon. Apparent diffusion coefficient (ADC) values were obtained from three ROIs placed over areas of most prominent diffusion restriction, and the mean value was used for analysis. Group comparisons were performed using the Mann-Whitney U, chi-square, and Fisher-Freeman-Halton tests, and diagnostic performance was assessed with ROC analysis.
Results:
Several MRI features differed significantly between IGM and IBC. Retroareolar involvement was more frequent in IGM (58.7% vs. 20.0%, p < 0.001). IGM commonly presented as combined mass and non-mass enhancement or isolated non-mass enhancement, whereas IBC predominantly appeared as solid masses. Abscess formation (71.1% vs. 1.7%, p < 0.001) and fistulae (56.2% vs. 0%) were characteristic of IGM. Segmental or multiregional non-mass enhancement patterns favored IGM. Mean ADC values were higher in IGM than in IBC, and an ADC threshold ≤895 × 10-6 mm2/s showed high specificity for IBC.
Conclusion:
Despite overlapping MRI findings, younger age, retroareolar involvement, multiregional non-mass enhancement, abscess and fistula formation, and higher ADC values favor IGM over IBC. MRI may improve diagnostic confidence and guide clinical management in suspected IGM, although histopathological confirmation remains essential.
