Granulomatous mastitis: changing clinical and imaging features with image-guided biopsy correlation
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To review clinical presentation, revisit patient demographics and imaging findings in granulomatous mastitis and determine the optimal biopsy method for diagnosis.
A retrospective study was performed to review the clinical presentation, imaging findings and biopsy methods in patients with granulomatous mastitis. Twenty-seven patients with pathology-proven granulomatous mastitis were included.
The average age at presentation was 38.0 years (range, 21–73 years). Seven patients were between 48 and 73 years old. Twenty-four patients presented with symptoms and three patients were asymptomatic. Nineteen patients were imaged with mammography demonstrating mammographically occult lesions as the predominant finding. Twenty-six patients were imaged with ultrasound and the most common finding was a mass lesion. Pathological diagnosis was made by image-guided biopsy in 44 % of patients. The imaging features of granulomatous mastitis on mammography are infrequently described.
Our study demonstrates that granulomatous mastitis can occur in postmenopausal or asymptomatic patients, although previously reported exclusively in young women with palpable findings. Presentation on mammography as calcifications requiring mammographically guided vacuum-assisted biopsy has not been previously described. The diagnosis of granulomatous mastitis can easily be made by image-guided biopsy and surgical excision should be reserved for definitive treatment.
• Characterizes radiographic appearance of granulomatous mastitis in postmenopausal or asymptomatic patients.
• Granulomatous mastitis can present exclusively as calcifications on mammography.
• The diagnosis of granulomatous mastitis is made by image-guided biopsy techniques.
KeywordsGranulomatous mastitis Core needle biopsy Mammography Ultrasound, mammary Breast neoplasms
The scientific guarantor of this publication is A. Jill Leibman. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was not required because due to the study design, which was a retrospective chart review. Written informed consent was not required for this study due to study design which only required a retrospective chart review without modification of diagnostic or therapeutic regimen. Animals were not used in this study. Study subjects or cohorts have not been previously reported. Methodology: retrospective, observational, multicentre study.
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