BREAST INFECTION - MAMMOGRAPHIC AND SONOGRAPHIC FINDINGS WITH CLINICAL CORRELATION

RATIONALE AND OBJECTIVES. TO characterize the mammographic, sonographi c, and clinical findings of breast infection and to determine characte ristics that could help differentiate it from inflammatory breast carc inoma. METHODS. The mammograms, sonograms, and clinical records of 21 consecutive patients who had mammography or sonography within 48 hours of presenting with breast infection were retrospectively reviewed. To exclude other causes of breast inflammation, patients were required t o have histologic or aspiration results specific for infection. RESULT S. Twelve of 19 (63%) mammograms were abnormal. Mammographic abnormali ties included an irregular mass (6; 32%), focal asymmetric density (2; 11%), diffuse asymmetric density (2; 11%), circumscribed mass (1; 5%) , and architectural distortion (1; 5%). Mammographic skin thickening, present in four (21%) patients, was focal in three and diffuse in one patient with primary breast Mycobacterium tuberculosis infection. No a bnormally dense lymph nodes were demonstrated. There was no abnormal s oft tissue gas. All 11 (100%) sonograms showed heterogeneous masses th at contained internal echoes, 5 of these in patients who had normal ma mmograms. All 21 patients presented with clinical abnormalities, inclu ding palpable mass (20; 95%), pain (11; 52%), erythema (11; 52%), warm th (7; 33%), skin thickening or fixation (4; 19%), and breast swelling (3; 14%). One patient was lactating. CONCLUSIONS. Mammographic, sonog raphic, and clinical abnormalities were usually present with breast in fection that could mimic inflammatory carcinoma. However, diffuse mamm ographic skin thickening, edema, and dense lymph nodes were rare, and when present may prospectively suggest carcinoma or an unusual infecti on. Early surgical consultation is advised.