Integration of magnetic resonance imaging in characterization of inflammatory breast disorders

Objective

Assess the efficacy of using different imaging modalities aiming at proper characterization of benign and malignant inflammatory breast disorders.

Methods

A prospective study included 34 patients presenting with clinical signs of mastitis. The patients underwent imaging according to clinical status (mammography, ultrasound and Magnetic resonance imaging) and the signs encountered in each modality were tested for their efficiency to discriminate benign from malignant inflammatory breast disorders.

Results

Benign mastitis was finally diagnosed in 23 cases (67.4%) while 11 patients as malignant including inflammatory breast carcinoma.Mammogram was done in 22/34 cases (64.7%). The final diagnostic indices of mammography showed sensitivity 33.3%, specificity 61.54%, PPV 37.5%, NPV 57.14% and efficacy 50%.Ultrasound was done for all cases (34/34, 100%) with sensitivity 58.33%, specificity 72.73%, PPV 53.85%, NPV 76.19% and efficacy 67.6%.MRI was done for all cases (34/34, 100%) with sensitivity 91.67%, specificity 100%, PPV 100%, NPV of 95.65% and efficacy 97.1%.

Conclusion

Diagnostic approach to inflammatory disorders includes multi-imaging modalities. Each modality plays a specific role in diagnosis with the highest specificity encountered on MRI evaluation followed by ultrasound and limited specificity on mammographic evaluation. It is essential to discriminate benign from malignant etiologies as there are major differences in their prognosis, and treatment options.