Korean J Radiol.  2011 Feb;12(1):113-121. 10.3348/kjr.2011.12.1.113.

Diffuse Infiltrative Lesion of the Breast: Clinical and Radiologic Features

• An YY
• Kim SH
• Cha ES
• Kim HS
• Kang BJ
• Park CS
• Jung NY
• Whang IY
• Yoon SK

• KMID: 991689
• DOI: http://doi.org/10.3348/kjr.2011.12.1.113

Abstract

The purpose of this paper is to show the clinical and radiologic features of a variety of diffuse, infiltrative breast lesions, as well to review the relevant literature. Radiologists must be familiar with the various conditions that can diffusely involve the breast, including normal physiologic changes, benign disease and malignant neoplasm.

Keyword

Breast; Breast ultrasonography or mammography; Magnetic resonance imaging

MeSH Terms

Adult
Aged
Aged, 80 and over
Breast Diseases/*diagnosis/pathology
Breast Neoplasms/diagnosis/pathology/secondary
Female
Humans
Magnetic Resonance Imaging
Mammography
Middle Aged
Tomography, X-Ray Computed
Ultrasonography, Mammary

Figure

• 

  Fig. 1 Lactating breast in 31-year-old woman with past history of thyroidectomy due to thyroid cancer. Patient was nursing her infant with only her left breast. A. Mammogram shows asymmetrical enlargement of left breast with diffuse increase in density. B. Ultrasonogram of left breast reveals diffuse enlargement of glandular component with duct ectasia (arrows). C. FDG PET scanning shows diffuse and intense uptake in left breast (SUVmax = 4.7).

• 

  Fig. 2 Puerperal mastitis with abscess secondary to Staphylococcus hominis infection in 28-year-old lactating woman. A. Mammogram shows diffuse increase in density and trabecular thickening of left breast. B. Ultrasonogram show irregular, hypoechoic fluid collections that suggest abscess (arrows). Note edematous change of overlying skin and subcutaneous fat.

• 

  Fig. 3 Granulomatous mastitis in 31-year-old woman who was currently breast feeding at two years' postpartum. A. Mammogram shows asymmetric increased density in left breast. B. Ultrasonogram shows ill-defined, irregular tubular, heterogeneous hypoechoic lesion involving left breast (arrows). Note vascularity immediately adjacent to lesion on Doppler sonography.

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  Fig. 4 Pseudoangiomatous stromal hyperplasia in 47-year-old woman. A. Ultrasonogram demonstrates heterogeneously hypoechoic lesion with scattered cystic spaces (arrows) involving entire left breast. B. MRI of breast shows scattered cystic spaces of high signal intensity (black arrow) between diffuse and nodular low signals (white double arrows) on fat-saturated HASTE T2 image (TR/TE = 1100/118, flip angle: 150°). C. Fibrous tissue with low signal intensity on T2 image (white double arrows in B) shows homogeneous enhancement on contrast-enhanced T1 weighted image with fat suppression. (Material in Fig. 4 is quoted from Ryu et al.'s case report, which was published in Korean J Radiology in 2010).

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  Fig. 5 Left breast edema associated with left lung cancer in 89-year-old woman. Mammogram shows diffusely increased density with skin thickening and trabecular thickening of left breast.

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  Fig. 6 Hemangioma of left breast with long-standing reddish purple skin change in 70-year-old woman. A. Mammogram shows diffusely increased density and trabecular thickening with enlargement of left breast. B. Ultrasonogram shows diffusely increased echogenicity of overlying subcutaneous fat layer of left breast.

• 

  Fig. 7 Inflammatory breast cancer in 52-year-old woman. A. Mammogram shows diffusely increased density, trabecular thickening and skin thickening of left breast. B. Ultrasonogram of left breast shows marked skin thickening, subcutaneous edema and dilated lymphatic channels (arrows), which are all typical of breast edema pattern. C. Axial contrast-enhanced T1 weighted image shows diffuse, infiltrative, non-mass enhancement involving entire left breast (TR/TE = 5.1/2.5). D. FDG PET scanning shows diffuse uptake of right breast with focal uptake on overlying thicken skin (SUVmax = 2.3).

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  Fig. 8 Invasive lobular carcinoma in 50-year-old woman who presented with hardness and decrease in size of right breast. A. Mammogram shows diffuse skin thickening and trabecular thickening of right breast. B. Ultrasonogram of right breast shows diffuse posterior acoustic shadowing without discrete mass. C, D. Sagittal (C) and axial (D) contrast-enhanced T1 weighted images, respectively, reveal non-mass enhancement involving nearly entire right breast (TR/TE = 4.2/2.0).

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  Fig. 9 Secondary lymphoma to breast in 78-year-old woman with left breast enlargement. A. Mammogram shows diffuse increased opacity throughout entire left breast with skin thickening. Note enlarged lymph nodes in left axilla on left mediolateral oblique mammogram. B. Ultrasonogram shows diffuse skin and subcutaneous edema of left breast. C. Sagittal T2 weighted image shows diffuse breast edema of high signal intensity in left breast (TR/TE = 4000/81.9).

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  Fig. 10 Metastatic rhabdomyosarcoma to breasts in 30-year-old woman with bilateral enlargement of breasts. She had history of sinonasal rhabdomyosarcoma that was treated by chemotherapy and radiation therapy 21 months previously. A. Chest CT scan shows dense parenchyma with subtle nodular infiltration in both breasts. B. Ultrasonogram shows heterogeneous, infiltrative hypoechoic lesion that occupies majority of breast parenchyma.

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