Differential diagnosis of imaging findings between patients with triple-negative breast cancer andpatients with idiopathic granulomatous mastitis
HAO Liang1, YU Ri-sheng1, CUI Feng2, REN Xing-chang2, XU Hai-bin2, DU Fang2, XU Kun-yuan2
1. Department of Radiology, the Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310009, China;2. Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310007, China
Abstract：Objective: To analyze the imaging findings of triple-negative breast cancer(TNBC) and to improve the understanding and diagnostic performance of the disease, by comparing it with idiopathic granulomatous mastitis(IGM). Methods: The imaging findings in 63 randomly assigned women with surgically and pathologically confirmed TNBC(n=45) and IGM(n=18) were retrospectively analyzed. All cases underwent a mammographic examination. An ultrasonic examination was performed in 37 cases of TNBC and 18 cases of IGM. MR examination was performed in 33 cases of TNBC and 14 cases of IGM. The mammographic imaging findings included lesion shape, density, margin, calcification, axillary adenopathy and thickening of the skin. The ultrasound imaging findings included shape, margin, size, echo, axillary adenopathy and thickening of the skin. The MR imaging findings included tumor shape, size, margin and internal enhancement, signal intensity within the tumor as well as peripheral signal intensity on T2-weighted, then the type of time-signal intensity curve(TIC) was analyzed. Results: The results of comparing TNBC group with IGM group showed as follows: ①Mammography imaging findings: mass type accounts for 67%(30/45) in TNBC group and 39%(7/18) in IGM group. Smooth margin of the lesion accounts for 60%(18/30) in TNBC group, while 29%(2/7) in IGM group.②Ultrasound imaging findings: mass type accounts for 92%(34/37) in TNBC group and 89%(16/18) in IGM group. Smooth margin of the lesion accounts for 62%(21/34) in TNBC group, while 37%(6/16) in IGM group.③MR imaging findings: mass type accounts for 91%(30/33) in TNBC group and 86%(12/14) in IGM group. Rim enhancement accounts for 67%(20/30) in TNBC group and 75%(9/12) in IGM group. For the rim enhancement mass type, smooth margin of the lesion accounts for 70%(14/20) in TNBC group, while 11%(1/9) in IGM group; peripheral hyperintense pattern on T2-weighted accounts for 85%(17/20) in TNBC group and 21%(2/9) in IGM group. Conclusion: We believe that through careful observation of the lesion site, shape, edge of the tumor mass and peripheral signal intensity on T2-weighted, enhancement pattern and the TIC types, might be useful for the identification of TNBC and IGM.
2011, Vol. 22 
