Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Insights into Imaging
Published in: Insights into Imaging 1/2021

Open Access 01-12-2021 | Mastitis | Educational Review

Mimickers of breast malignancy: imaging findings, pathologic concordance and clinical management

Authors: Mary S. Guirguis, Beatriz Adrada, Lumarie Santiago, Rosalind Candelaria, Elsa Arribas

Published in: Insights into Imaging | Issue 1/2021

Login to get access

Abstract

Many benign breast entities have a clinical and imaging presentation that can mimic breast cancer. The purpose of this review is to illustrate the wide spectrum of imaging features that can be associated with benign breast diseases with an emphasis on the suspicious imaging findings associated with these benign conditions that can mimic cancer. As radiologic-pathologic correlation can be particularly challenging in these cases, the radiologist’s familiarity with these benign entities and their imaging features is essential to ensure that a benign pathology result is accepted as concordant when appropriate and that a suitable management plan is formulated.
Literature
1.
Sabaté JM, Clotet M, Gómez A, De Las HP, Torrubia S, Salinas T (2005) Radiologic evaluation of uncommon inflammatory and reactive breast disorders. Radiographics 25(2):411–424PubMed
2.
Trop I, Dugas A, David J et al (2011) Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics 31(6):1683–1699PubMed
3.
Schäfer P, Fürrer C, Mermillod B (1988) An association of cigarette smoking with recurrent subareolar breast abscess. Int J Epidemiol 17(4):810–813PubMed
4.
Rizzo M, Gabram S, Staley C et al (2010) Management of breast abscesses in nonlactating women. Am Surg 76(3):292–295PubMed
5.
Berna-Serna JD, Madrigal M (2004) Percutaneous management of breast abscesses. An experience of 39 cases. Ultrasound Med Biol 30(1):1–6PubMed
6.
Eryilmaz R, Sahin M, Hakan Tekelioglu M, Daldal E (2004) Management of lactational breast abscesses. Breast 14(5):375–379
7.
Chow CK (2005) Imaging in inflammatory breast carcinoma. Breast Dis 22:45–54PubMed
8.
Nguyen SL, Doyle AJ, Symmans PJ (2000) Interstitial fluid and hypoechoic wall: two sonographic signs of breast abscess. J Clin Ultrasound 28(7):319–324PubMed
9.
Fletcher A, Magrath IM, Riddell RH, Talbot IC (1982) Granulomatous mastitis: a report of seven cases. J Clin Pathol 35(9):941–945PubMedPubMedCentral
10.
11.
Hovanessian Larsen LJ, Peyvandi B, Klipfel N, Grant E, Iyengar G (2009) Granulomatous lobular mastitis: imaging, diagnosis, and treatment. AJR Am J Roentgenol 193(2):574–581PubMed
12.
Han BK, Choe YH, Park JM et al (1999) Granulomatous mastitis: mammographic and sonographic appearances. AJR Am J Roentgenol 173(2):317–320PubMed
13.
Yilmaz E, Lebe B, Usal C, Balci P (2001) Mammographic and sonographic findings in the diagnosis of idiopathic granulomatous mastitis. Eur Radiol 11(11):2236–2240PubMed
14.
Memis A, Bilgen I, Ustun EE, Ozdemir N, Erhan Y, Kapkac M (2002) Granulomatous mastitis: imaging findings with histopathologic correlation. Clin Radiol 57(11):1001–1006PubMed
15.
Poyraz N, Emlik GD, Batur A, Gundes E, Keskin S (2016) Magnetic resonance imaging features of idiopathic granulomatous mastitis: a retrospective analysis. Iran J Radiol 13(3):e20873PubMedPubMedCentral
16.
Rieber A, Tomczak RJ, Mergo PJ, Wenzel V, Zeitler H, Brambs HJ (1997) MRI of the breast in the differential diagnosis of mastitis versus inflammatory carcinoma and follow-up. J Comput Assist Tomogr 21:128–132PubMed
17.
de Bazelaire C, Groheux D, Chapellier M et al (2012) Breast inflammation: indications for MRI and PET-CT. Diagn Interv Imaging 93:104–115PubMed
18.
Sripathi S, Ayachit A, Bala A, Kadavigere R, Kumar S (2016) Idiopathic granulomatous mastitis: a diagnostic dilemma for the breast radiologist. Insights Imaging 7(4):523–529PubMedPubMedCentral
19.
Patel RA, Strickland P, Sankara IR, Pinkston G, Many W, Rodriguez M (2010) Idiopathic granulomatous mastitis: case reports and review of literature. J Gen Intern Med 25(3):270–273PubMed
20.
Lai EC, Chan WC, Ma TK, Tang AP, Poon CS, Leong HT (2005) The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 11(6):454–456PubMed
21.
Ely KA, Tse G, Simpson JF, Clarfeld R, Page DL (2000) Diabetic mastopathy. A clinicopathologic review. Am J Clin Pathol 113(4):541–545PubMed
22.
Thorncroft K, Forsyth L, Desmond S, Audisio RA (2007) The diagnosis and management of diabetic mastopathy. Breast J 13(6):607–613PubMed
23.
Pereira MA, de Magalhães AV, da Motta LD et al (2010) Fibrous mastopathy: clinical, imaging, and histopathologic findings of 31 cases. J Obstet Gynaecol Res 36(2):326–335PubMed
24.
Chan CL, Ho RS, Shek TW, Kwong A (2013) Diabetic mastopathy. Breast J 19(5):533–538PubMed
25.
Valdez R, Thorson J, Finn WG, Schnitzer B, Kleer CG (2003) Lymphocytic mastitis and diabetic mastopathy: a molecular, immunophenotypic, and clinicopathologic evaluation of 11 cases. Mod Pathol 16(3):223–228PubMed
26.
Goulabchand R, Hafidi A, Van de Perre P et al (2020) Mastitis in autoimmune diseases: review of the literature, diagnostic pathway, and pathophysiological key players. J Clin Med 9(4):958PubMedCentral
27.
Weinstein SP, Conant EF, Orel SG, Lawton TJ, Acs G (2001) Diabetic mastopathy in men: imaging findings in two patients. Radiology 219(3):797–799PubMed
28.
Wong KT, Tse GM (2002) Yang WT (2002) Ultrasound and MR imaging of diabetic mastopathy. Clin Radiol 57(8):730–735PubMed
29.
Sakuhara Y, Shinozaki T, Hozumi Y, Ogura S, Omoto K, Furuse M (2002) MR imaging of diabetic mastopathy. AJR Am J Roentgenol 179(5):1201–1203PubMed
30.
Tuncbilek N, Karakas HM, Okten O (2004) Diabetic fibrous mastopathy: dynamic contrast-enhanced magnetic resonance imaging findings. Breast J 10(4):359–362PubMed
31.
Tayyab SJ, Adrada BE, Rauch GM, Yang WT (2018) A pictorial review: multimodality imaging of benign and suspicious features of fat necrosis in the breast. Br J Radiol 91(1092):20180213PubMedPubMedCentral
32.
Nakada H, Inoue M, Furuya K et al (2019) Fat necrosis after breast-conserving oncoplastic surgery. Breast Cancer 26(1):125–130PubMed
33.
Shin S, Ko ES, Han BK, Ko EY (2014) Stromal fibrosis of the breast: outcome analysis. Acta Radiol 55(4):409–415PubMed
34.
Lee SJ, Mahoney MC, Khan S (2011) MRI features of stromal fibrosis of the breast with histopathologic correlation. AJR Am J Roentgenol 197(3):755–762PubMed
35.
Malik N, Lad S, Seely JM, Schweitzer ME (2014) Underestimation of malignancy in biopsy-proven cases of stromal fibrosis. Br J Radiol 87(1039):20140182PubMedPubMedCentral
36.
Yilmaz R, Bayramoglu Z, Kartal MG et al (2018) Stromal fibrosis: imaging features with diagnostic contribution of diffusion-weighted MRI. Br J Radiol 91(1085):20170706PubMedPubMedCentral
37.
Sklair-Levy M, Samuels TH, Catzavelos C, Hamilton P, Shumak R (2001) AJR Am J Roentgenol 177(3):573–577PubMed
38.
Cho SH, Park SH (2013) Mimickers of breast malignancy on breast sonography. J Ultrasound Med 32(11):2029–2036PubMed
39.
40.
Presazzi A, Di Giulio G, Calliada F (2015) Breast hamartoma: ultrasound, elastosonographic, and mammographic features. Mini pictorial essay J Ultrasound 18(4):373–377PubMed
41.
Charpin C, Mathoulin M, Andrac L et al (1994) Reappraisal of breast hamartomas: a morphological study of 41 cases. Pathol Res Pract 190(4):362–371PubMed
42.
Adrada BE, Krishnamurthy S, Carkaci S, Posleman-Monetto FE, Ewere A, Whitman GJ (2015) Unusual benign tumors of the breast. J Clin Imaging Sci 5:27PubMedPubMedCentral
43.
Raj SD, Sahani VG, Adrada BE et al (2017) Pseudoangiomatous stromal hyperplasia of the breast: multimodality review with pathologic correlation. Curr Probl Diagn Radiol 46(2):130–135PubMed
44.
Ferreira M, Albarracin CT, Resetkova E (2008) Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases. Mod Pathol 21(2):201–207PubMed
45.
Powell CM, Cranor ML (1995) Rosen PP (1995) Pseudoangiomatous stromal hyperplasia (PASH): a mammary stromal tumor with myofibroblastic differentiation. Am J Surg Pathol 19(3):270–277PubMed
46.
Drinka EK, Bargaje A, Erşahin ÇH et al (2012) Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a clinicopathological study of 79 cases. Int J Surg Pathol 20(1):54–58PubMed
47.
Ibrahim RE, Sciotto CG, Weidner N (1989) Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer 63(6):1154–1160PubMed
48.
Jones KN, Glazebrook KN, Reynolds C (2010) Pseudoangiomatous stromal hyperplasia: imaging findings with pathologic and clinical correlation. AJR Am J Roentgenol 195(4):1036–1042PubMed
49.
Cohen MA, Morris EA, Rosen PP, Dershaw DD, Liberman L, Abramson AF (1996) Pseudoangiomatous stromal hyperplasia: mammographic, sonographic, and clinical patterns. Radiology 198(1):117–120PubMed
50.
Solomou E, Kraniotis P, Patriarcheas G (2012) A case of a giant pseudoangiomatous stromal hyperplasia of the breast: magnetic resonance imaging findings. Rare Tumors 4(2):73–77
51.
Hargaden GC, Yeh ED, Georgian-Smith D et al (2008) Analysis of the mammographic and sonographic features of pseudoangiomatous stromal hyperplasia. AJR Am J Roentgenol 191(2):359–363PubMed
52.
Nassar H, Elieff MP, Kronz JD, Argani P (2010) Pseudoangiomatous stromal hyperplasia (PASH) of the breast with foci of morphologic malignancy: a case of PASH with malignant transformation? Int J Surg Pathol 18(6):564–569PubMed
53.
Smilg P (2018) Pseudoangiomatous stromal hyperplasia: presentation and management—a clinical perspective. SA J Radiol 22(2):1366PubMedPubMedCentral
54.
Bowman E, Oprea G, Okoli J et al (2012) Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a series of 24 patients. Breast J 18(3):242–247PubMedPubMedCentral
55.
Yoon KH, Koo B, Lee KB et al (2020) Optimal treatment of pseudoangiomatous stromal hyperplasia of the breast. Asian J Surg 43(7):735–741PubMed
56.
Sengupta S, Pal S, Biswas BK, Phukan JP, Sinha A, Sinha R (2014) Preoperative diagnosis of tubular adenoma of breast–10 years of experience. N Am J Med Sci 6(5):219PubMedPubMedCentral
57.
Salemis NS, Gemenetzis G, Karagkiouzis G et al (2012) Tubular adenoma of the breast: a rare presentation and review of the literature. J Clin Med Res 4(1):64PubMedPubMedCentral
58.
Tavasoli F, Deville P (2003) WHO classification of tumours, tumours of the breast and female genital organs. IARC Press, pp 153–158
59.
Maiorano E, Albrizio M (1995) Tubular adenoma of the breast: an immunohistochemical study of ten cases. Pathol Res Pract 191(12):1222–1230PubMed
60.
O’Hara MF, Page DL (1985) Adenomas of the breast and ectopic breast under lactational influences. Hum Pathol 16(7):707–712PubMed
61.
Soo MS, Dash N, Bentley R, Lee LH, Nathan G (2000) Tubular adenomas of the breast: imaging findings with histologic correlation. AJR Am J Roentgenol 174(3):757–761PubMed
62.
Tavassoli FA (1999) Pathology of the breast. McGraw Hill Professional
63.
Eastley N, McCulloch T, Esler C et al (2016) Extra-abdominal desmoid fibromatosis: a review of management, current guidance and unanswered questions. Eur J Surg Oncol 42(7):1071–1083PubMed
64.
Neuman HB, Brogi E, Ebrahim A, Brennan MF, Van Zee KJ (2008) Desmoid tumors (fibromatoses) of the breast: a 25-year experience. Ann Surg Oncol 15(1):274–280PubMed
65.
Glazebrook KN, Reynolds CA (2009) Mammary fibromatosis. AJR Am J Roentgenol 193(3):856–860PubMed
66.
Cederlund C-G, Gustavsson S, Linell F, Moquist-Olsson I, Andersson I (1984) Fibromatosis of the breast mimicking carcinoma at mammography. Br J Radiol 57(673):98–101PubMed
67.
Leibman A, Kossoff M (1991) Sonographic features of fibromatosis of the breast. J Ultrasound Med 10(1):43–45PubMed
68.
Linda A, Londero V, Bazzocchi M, Zuiani C (2008) Desmoid tumor of the breast: radiologic appearance with a focus on its magnetic resonance features. Breast J 14(1):106PubMed
69.
Nakazono T, Satoh T, Hamamoto T, Kudo S (2003) Dynamic MRI of fibromatosis of the breast. AJR Am J Roentgenol 181(6):1718–1719PubMed
70.
Alman B, Attia S, Baumgarten C et al (2020) The management of desmoid tumours: a joint global consensus-based guideline approach for adult and paediatric patients. Eur J Cancer 127:96–107
71.
Fiore M, Rimareix F, Mariani L et al (2009) Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment. Ann Surg Oncol 16(9):2587–2593PubMed
72.
Bonvalot S, Ternès N, Fiore M et al (2013) Spontaneous regression of primary abdominal wall desmoid tumors: more common than previously thought. Ann Surg Oncol 20(13):4096–4102PubMed
73.
Kasper B, Baumgarten C, Garcia J, et al (2017) An update on the management of sporadic desmoid-type fibromatosis: a European Consensus Initiative between Sarcoma PAtients EuroNet (SPAEN) and European Organization for Research and Treatment of Cancer (EORTC)/Soft Tissue and Bone Sarcoma Group (STBSG). Ann Oncol 28(10):2399–2408PubMedPubMedCentral
74.
Duazo-Cassin L, Le Guellec S, Lusque A et al (2019) Breast desmoid tumor management in France: toward a new strategy. Breast Cancer Res Treat 176(2):329–335PubMed
75.
Lorenzen J, Cramer M, Buck N et al (2019) Desmoid type fibromatosis of the breast: ten-year institutional results of imaging, histopathology, and surgery. Breast Care 16:77–84
76.
77.
Jagannathan DM (2015) Benign granular-cell tumor of the breast: case report and literature review. Radiol Case Rep 10(2):1116PubMed
78.
Scaranelo A, Bukhanov K, Crystal P, Mulligan AM, O’malley FP, (2007) Granular cell tumour of the breast: MRI findings and review of the literature. Br J Radiol 80(960):970–974PubMed
79.
Hoess C, Freitag K, Kolben M et al (1998) FDG PET evaluation of granular cell tumor of the breast. J Nucl Med 39(8):1398–1401PubMed
80.
Brown AC, Audisio RA, Regitnig P (2011) Granular cell tumour of the breast. Surg Oncol 20(2):97–105PubMed
Metadata
Title
Mimickers of breast malignancy: imaging findings, pathologic concordance and clinical management
Authors
Mary S. Guirguis
Beatriz Adrada
Lumarie Santiago
Rosalind Candelaria
Elsa Arribas
Publication date
01-12-2021
Publisher
Springer International Publishing
Published in
Insights into Imaging / Issue 1/2021
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-021-00991-x

Other articles of this Issue 1/2021

Insights into Imaging 1/2021 Go to the issue

Statement

European consensus on patient contact shielding

Correction

Correction to: Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19

Original Article

The preoperative localisation of small parathyroid adenomas improves when adding Tc-99m-Sestamibi SPECT to multiphase contrast-enhanced CT

Original Article

Giant cell tumour of the tendon sheath of the spine: clinical features and imaging findings

Educational Review

Microbleeds show a characteristic distribution in cerebral fat embolism

Educational Review

Errors, discrepancies and underlying bias in radiology with case examples: a pictorial review