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Congress: ECR25
Poster Number: C-16181
Type: Poster: EPOS Radiologist (educational)
DOI: 10.26044/ecr2025/C-16181
Authorblock: E. Meltem, S. E. Ata, M. Baykara Ulusan, H. Özdemir, A. S. Mahmutoglu; Istanbul/TR
Disclosures:
Emine Meltem: Research/Grant Support: EUSOBI Young researcher grant
Sevcan Emine Ata: Nothing to disclose
Melis Baykara Ulusan: Nothing to disclose
Hanife Özdemir: Nothing to disclose
Abdullah Soydan Mahmutoglu: Nothing to disclose
Keywords: Breast, Mammography, MR, Ultrasound, Biopsy, Abscess, Inflammation
Learning objectives To differentiate idiopathic granulomatous mastitis (IGM) from malignancy using imaging modalities ultrasound, mammography, and MRI. To highlight the typical and atypical imaging features of IGM, aiding in accurate diagnosis and prompt treatment.
Read more Background Idiopathic granulomatous mastitis (IGM) is a rare, benign chronic inflammatory breast condition that can clinically and radiologically mimic breast cancer[1].  It was first described by Kessler and Wolloch in 1972 [2]. The exact cause remains unknown, though an autoimmune response has been proposed. IGM primarily occurs in premenopausal women, often following pregnancy or breastfeeding. Various factors have been proposed to contribute to the etiology of the disease, including hormonal imbalances, autoimmunity, unidentified microbiological agents, smoking, and α1-antitrypsin deficiency[3]. Interestingly, the...
Read more Findings and procedure details Typical and atypical imaging features of IGM:Ultrasound: Ultrasound findings are variable, ranging from a large hypoechoic mass to multiple clustered, often contiguous hypoechoic lesions with tubular extensions and with posterior acoustic shadowing[7]. According to a retrospective study involving over 200 patients, the most common ultrasound presentation of IGM is a large, irregular hypoechoic mass with tubular extensions (59%) [8]. Other ultrasound appearances include mass lesions with angular, lobulated, or indistinct margins; heterogeneous breast parenchyma; circumscribed hypoechoic masses; and parenchymal distortion with...
Read more Conclusion Recognizing the imaging spectrum of IGM is crucial to prevent misdiagnosis as breast cancer. While inflammatory breast cancer and IGM can share many common imaging features, there are distinct findings that favor one diagnosis over the other, as highlighted in this poster. Multimodal imaging, combined with clinical and histopathological correlation, is essential for accurate diagnosis, minimizing unnecessary invasive procedures, and guiding appropriate management.
Read more References W, D., P, R., C, W., & Cb, G. (n.d.). Idiopathic granulomatous mastitis. A report of three cases and review of the literature. - Abstract—Europe PMC. Retrieved January 12, 2025, from https://europepmc.org/article/med/8060233 Kessler, E., & Wolloch, Y. (1972). Granulomatous Mastitis: A Lesion Clinically Simulating Carcinoma. American Journal of Clinical Pathology, 58(6), 642–646. https://doi.org/10.1093/ajcp/58.6.642 Altintoprak, F., Kivilcim, T., & Ozkan, O. V. (2014). Aetiology of idiopathic granulomatous mastitis. World Journal of Clinical Cases : WJCC, 2(12), 852–858. https://doi.org/10.12998/wjcc.v2.i12.852 Fazzio, R. T., Shah, S. S., Sandhu,...
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