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Radiology–Pathology Correlation: Inflammatory Conditions of the Breast

  • Best Practice Approaches Breast Radiology-Pathology Correlation and Management (J Scheel and MR Kilgore, Section Editors)
  • Published:
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Abstract

Purpose of Review

Inflammatory conditions of the breast can clinically and radiologically resemble malignant processes, constituting a diagnostic dilemma. Core needle biopsy, with special stains and microbiology, may be needed to help distinguish between benign inflammatory processes and malignancy. This article focuses on describing the common types of benign inflammatory-related pathologies in the breast with an emphasis on radiology–pathology correlation.

Recent Findings

We have classified these entities based on the types of inflammation seen at the time of pathologic diagnosis: acute inflammation and abscess formation, chronic inflammation, granulomatous inflammation, non-granulomatous inflammation, and vascular inflammation.

Summary

This review focuses on describing the common types of inflammation seen in the breast and will familiarize the reader to confidently perform and understand radiology–pathology correlation with these types of findings.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Berens P, Swaim L, Peterson B. Incidence of methicillin-resistant Staphylococcus aureus in postpartum breast abscesses. Breastfeed Med Off J Acad Breastfeed Med. 2010;5:113–5. https://doi.org/10.1089/bfm.2009.0030.

    Article  Google Scholar 

  2. Amir LH. ABM Clinical protocol #4: Mastitis, Revised March 2014. Breastfeed Med. 2014;9:239–43. https://doi.org/10.1089/bfm.2014.9984.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Foxman B, D’Arcy H, Gillespie B, Bobo JK, Schwartz K. Lactation mastitis: occurrence and medical management among 946 breastfeeding women in the United States. Am J Epidemiol. 2002;155:103–14. https://doi.org/10.1093/aje/155.2.103.

    Article  PubMed  Google Scholar 

  4. • Patel SH, Vaidya YH, Patel RJ, Pandit RJ, Joshi CG, Kunjadiya AP. Culture independent assessment of human milk microbial community in lactational mastitis. Sci Rep. 2017;7:1–11. https://doi.org/10.1038/s41598-017-08451-7. In this study, the authors utilize 16S rRNA gene sequencing to analyze breast milk samples from patient with acute mastitis, subacute mastitis and health control to demonstrate lower microbial diversity and higher abundance of opportunistic pathogens in patients with mastitis.

    Article  CAS  Google Scholar 

  5. • Jiménez E, Andrés J de, Manrique M, Pareja-Tobes P, Tobes R, Martínez-Blanch JF, et al. Metagenomic analysis of milk of healthy and mastitis-suffering women: J Hum Lact 2015. https://doi.org/10.1177/0890334415585078. Breast milk contains a complex microbial metagenome constituted by the genome of bacteria, archaea, viruses, fungi, and protozoa. The metagenome of milk from healthy women differs from that of women with mastitis.

  6. Angelopoulou A, Field D, Ryan CA, Stanton C, Hill C, Ross RP. The microbiology and treatment of human mastitis. Med Microbiol Immunol (Berl). 2018;207:83–94. https://doi.org/10.1007/s00430-017-0532-z.

    Article  Google Scholar 

  7. Sabate JM, Clotet M, Torrubia S, Gomez A, Guerrero R, de Las HP, et al. Radiologic Evaluation of breast disorders related to pregnancy and lactation. Radiographics. 2007;27:S101–24. https://doi.org/10.1148/rg.27si075505.

    Article  PubMed  Google Scholar 

  8. Tan H, Li R, Peng W, Liu H, Gu Y, Shen X. Radiological and clinical features of adult non-puerperal mastitis. Br J Radiol 2013;86. https://doi.org/10.1259/bjr.20120657.

  9. Versluijs-Ossewaarde FNL, Roumen RMH, Goris RJA. Subareolar breast abscesses: characteristics and results of surgical treatment. Breast J. 2005;11:179–82. https://doi.org/10.1111/j.1075-122X.2005.21524.x.

    Article  PubMed  Google Scholar 

  10. Kasales CJ, Han B, Smith JS, Chetlen AL, Kaneda HJ, Shereef S. Nonpuerperal mastitis and subareolar abscess of the breast. Am J Roentgenol. 2014;202:W133–9. https://doi.org/10.2214/AJR.13.10551.

    Article  Google Scholar 

  11. Ferris-James DM, Iuanow E, Mehta TS, Shaheen RM, Slanetz PJ. Imaging approaches to diagnosis and management of common ductal abnormalities. Radiographics. 2012;32:1009–30. https://doi.org/10.1148/rg.324115150.

    Article  PubMed  Google Scholar 

  12. Dixon JM, Ravisekar O, Chetty U, Anderson TJ. Periductal mastitis and duct ectasia: different conditions with different aetiologies. BJS Br J Surg. 1996;83:820–2. https://doi.org/10.1002/bjs.1800830630.

    Article  CAS  Google Scholar 

  13. Liu Y, Zhang J, Zhou Y-H, Jiang Y-N, Zhang W, Tang X-J, et al. IL-6/STAT3 signaling pathway is activated in plasma cell mastitis. Int J Clin Exp Pathol. 2015;8:12541–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. Dong Y, Yu J-J, Shibahara Y, Lu H-S, He H-Y, Liu J-D, et al. Intercellular adhesion molecule 1/2 and E-selectin in plasma cell mastitis: immunohistochemical study of 35 cases. Hum Pathol. 2014;45:606–10. https://doi.org/10.1016/j.humpath.2013.06.025.

    Article  CAS  PubMed  Google Scholar 

  15. Cutler M. Plasma-cell mastitis. Br Med J. 1949;1:94–6.

    Article  CAS  Google Scholar 

  16. Tayyab SJ, Adrada BE, Rauch GM, Yang WT. A pictorial review: multimodality imaging of benign and suspicious features of fat necrosis in the breast. Br J Radiol. 2018;91:20180213. https://doi.org/10.1259/bjr.20180213.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Fernandes Chala L, de Barros N, de Camargo MP, Endo É, Kim SJ, Maciel Pincerato K, et al. Fat necrosis of the breast: mammographic, sonographic, computed tomography, and magnetic resonance imaging findings. Curr Probl Diagn Radiol. 2004;33:106–26. https://doi.org/10.1067/j.cpradiol.2004.01.001.

    Article  Google Scholar 

  18. Ganau S, Tortajada L, Escribano F, Andreu X, Sentís M. The great mimicker: fat necrosis of the breast—magnetic resonance mammography approach. Curr Probl Diagn Radiol. 2009;38:189–97. https://doi.org/10.1067/j.cpradiol.2009.01.001.

    Article  PubMed  Google Scholar 

  19. Taboada JL, Stephens TW, Krishnamurthy S, Brandt KR, Whitman GJ. The Many faces of fat necrosis in the breast. Am J Roentgenol. 2009;192:815–25. https://doi.org/10.2214/AJR.08.1250.

    Article  Google Scholar 

  20. Shah AT, Jankharia BB. Imaging of common breast implants and implant-related complications: a pictorial essay. Indian J Radiol Imaging. 2016;26:216–25. https://doi.org/10.4103/0971-3026.184409.

    Article  PubMed  PubMed Central  Google Scholar 

  21. de Faria Castro Fleury E, D’Alessandro GS, Lordelo Wludarski SC. Silicone-Induced granuloma of breast implant capsule (SIGBIC): histopathology and radiological correlation. J Immunol Res 2018. https://doi-org.offcampus.lib.washington.edu/10.1155/2018/6784971.

  22. Seiler SJ, Sharma PB, Hayes JC, Ganti R, Mootz AR, Eads ED, et al. Multimodality imaging-based evaluation of single-lumen silicone breast implants for rupture. Radiographics. 2017;37:366–82. https://doi.org/10.1148/rg.2017160086.

    Article  PubMed  Google Scholar 

  23. Baek WY, Lew DH, Lee DW. A retrospective analysis of ruptured breast implants. Arch Plast Surg. 2014;41:734–9. https://doi.org/10.5999/aps.2014.41.6.734.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Brown SL, Middleton MS, Berg WA, Soo MS, Pennello G. Prevalence of rupture of silicone gel breast implants revealed on mr imaging in a population of women in Birmingham. Alabama Am J Roentgenol. 2000;175:1057–64. https://doi.org/10.2214/ajr.175.4.1751057.

    Article  CAS  Google Scholar 

  25. Middleton MS. MR evaluation of breast implants. Radiol Clin North Am. 2014;52:591–608. https://doi.org/10.1016/j.rcl.2014.02.013.

    Article  PubMed  Google Scholar 

  26. Taylor GB, Paviour SD, Musaad S, Jones WO, Holland DJ. A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology (Phila). 2003;35:109–19.

    Google Scholar 

  27. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol. 1972;58:642–6. https://doi.org/10.1093/ajcp/58.6.642.

    Article  CAS  PubMed  Google Scholar 

  28. • Pluguez-Turull CW, Nanyes JE, Quintero CJ, Alizai H, Mais DD, Kist KA, et al. Idiopathic granulomatous mastitis: manifestations at multimodality imaging and pitfalls. RadioGraphics. 2018;38:330–56. https://doi.org/10.1148/rg.2018170095. The authors review the clinical manifestations, imaging features, differential diagnoses, and histopathologic features of idiopathic granulomatous mastitis.

    Article  PubMed  Google Scholar 

  29. Wong KT, Tse GMK, Yang WT. Ultrasound and MR imaging of diabetic mastopathy. Clin Radiol. 2002;57:730–5. https://doi.org/10.1053/crad.2002.0936.

    Article  CAS  PubMed  Google Scholar 

  30. Sabaté JM, Clotet M, Gómez A, De las Heras P, Torrubia S, Salinas T. Radiologic evaluation of uncommon inflammatory and reactive breast disorders. RadioGraphics. 2005;25:411–24. https://doi.org/10.1148/rg.252045077.

    Article  PubMed  Google Scholar 

  31. Merlini G, Seldin DC, Gertz MA. Amyloidosis: pathogenesis and new therapeutic options. J Clin Oncol. 2011;29:1924–33. https://doi.org/10.1200/JCO.2010.32.2271.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Said SM, Reynolds C, Jimenez RE, Chen B, Vrana JA, Theis JD, et al. Amyloidosis of the breast: predominantly AL type and over half have concurrent breast hematologic disorders. Mod Pathol. 2013;26:232–8. https://doi.org/10.1038/modpathol.2012.167.

    Article  CAS  PubMed  Google Scholar 

  33. Charlot M, Seldin DC, O’hara C, Skinner M, Sanchorawala V. Localized amyloidosis of the breast: a case series. Amyloid. 2011;18:72–5. https://doi.org/10.3109/13506129.2011.570817.

    Article  PubMed  Google Scholar 

  34. Shim Y, Kim MJ, Ryu HS, Park SH. Primary breast amyloidosis presenting as microcalcifications only. Korean J Radiol. 2013;14:723–6. https://doi.org/10.3348/kjr.2013.14.5.723.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Huerter ME, Hammadeh R, Zhou Q, Weisberg A, Riker AI. Primary amyloidosis of the breast presenting as a solitary nodule: case report and review of the literature. Ochsner J. 2014;14:282–6.

    PubMed  PubMed Central  Google Scholar 

  36. Shetty MK, Watson AB. Mondor’s disease of the breast. Am J Roentgenol. 2001;177:893–6. https://doi.org/10.2214/ajr.177.4.1770893.

    Article  CAS  Google Scholar 

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Correspondence to Niketa Kataria.

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Kataria, N., Lam, D.L. & Parker, E.U. Radiology–Pathology Correlation: Inflammatory Conditions of the Breast. Curr Breast Cancer Rep 13, 282–295 (2021). https://doi.org/10.1007/s12609-021-00432-0

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