In this paper, we evaluate the radiological features of pregnancy-associated breast lesions and discuss the difficulties in diagnosis by imaging. We selected patients who were diagnosed with pregnancy-associated breast lesions during the previous 5 years. All patients complained of palpable lesions in the breast and underwent ultrasonographic (US) examination, the first choice for examination of pregnancy-related breast lesions. Any suspicious lesions found by the US were recommended for a US-guided core biopsy, US-guided fine needle aspiration (FNA), or surgery. Various breast lesions were detected during pregnancy and lactation, including breast cancer, mastitis and abscesses, lactating adenoma, galactoceles, lobular hyperplasia, and fibroadenomas. The imaging features of pregnancy-associated breast lesions did not differ from the features of non-pregnancy-associated breast lesions; however, some pregnancy-associated benign lesions had suspicious sonographic features. A US-guided core biopsy was necessary for differentiating benign from malignant. In patients with breast cancer, the cancer was often advanced at the time of diagnosis. In conclusion, various pregnancy-related breast lesions were detected and the imaging of these lesions had variable findings. Breast ultrasound could be an excellent imaging modality for diagnosis and differentiation between benign and malignant lesions. However, when the imaging results are suspicious, a biopsy should be performed to obtain a pathologic diagnosis.
Ultrasonography, Mammary ; Pregnancy Complications/diagnosis/*radiography/surgery ; Pregnancy ; *Mammography ; Humans ; Female ; Breast Neoplasms/pathology/radiography/ultrasonography ; Breast Diseases/pathology/*radiography/ultrasonography ; Breast/pathology/surgery ; Biopsy ; Adult

A case of breast sparganosis was confirmed by surgical excision of a worm (fragmented into 5 pieces) in a 59-year-old Korean woman suffering from a palpable mass in the left breast. Mammography and ultrasonography characteristically revealed the presence of several well-defined, isodense and hypoechoic tubular masses, in the upper quadrant of the left breast, each mass consisting of a continuous cord- or worm-like structure. During surgery, a long segment of an actively moving sparganum of Spirometra sp. and 4 small fragments of the same worm, giving a total length of 20.3 cm, were extracted from the upper outer quadrant of the left breast and the axillary region. The infection source remains unclear, because the patient denied ingesting any snake or frog meat or drinking untreated water.
Middle Aged ; Humans ; Female ; Diphyllobothriasis/*diagnosis/parasitology/pathology ; Breast Diseases/*parasitology/pathology/*surgery

OBJECTIVE: To investigate the usefulness of targeted ultrasound (US) in the identification of additional suspicious lesions found by magnetic resonance (MR) imaging in breast cancer patients and the changes in treatment based on the identification of the lesions by the use of targeted US. MATERIALS AND METHODS: One-hundred forty nine patients who underwent breast MR imaging for a preoperative evaluation of breast cancer between January 2002 and July 2004 were included in the study. We searched all cases for any additional lesions that were found initially by MR imaging and investigated the performance of targeted US in identifying the lesions. We also investigated their pathological outcomes and changes in treatment as a result of lesion identification. RESULTS: Of the 149 patients with breast cancer, additional suspicious lesions were detected with MR imaging in 62 patients (42%). Of the 69 additional lesions found in those 62 patients, 26 (38%) were confirmed as cancers by histology. Thirty-eight lesions in 31 patients were examined with targeted US and were histologically revealed as cancers in 18 (47%), high risk lesions in two (5%), benign lesions in 15 (39%), and unidentified lesions in three (8%). The cancer rate was statistically higher in lesions with a US correlate than in lesions without a US correlate (p = 0.028). Of 31 patients, the surgical plan was altered in 27 (87%). The use of targeted US justified a change in treatment for 22 patients (81%) and misled five patients (19%) into having an unnecessary surgical excision. CONCLUSION: Targeted US can play a useful role in the evaluation of additional suspicious lesions detected by MR imaging in breast cancer patients, but is limited in lesions without a US correlate.
Adult ; Aged ; Biopsy ; Breast/pathology ; Breast Diseases/diagnosis/surgery ; Breast Neoplasms/*diagnosis/surgery ; Carcinoma, Ductal, Breast/*diagnosis/surgery ; Carcinoma, Intraductal, Noninfiltrating/*diagnosis/surgery ; Carcinoma, Lobular/*diagnosis/surgery ; Contrast Media/administration & dosage ; Diagnosis, Differential ; False Negative Reactions ; False Positive Reactions ; Female ; Humans ; Image Enhancement/methods ; Imaging, Three-Dimensional/methods ; Magnetic Resonance Imaging/*methods ; Middle Aged ; Predictive Value of Tests ; Sensitivity and Specificity ; Ultrasonography, Mammary/*methods

Cholesterol granuloma of the breast is a rare, benign disease. Here, we present the unique ultrasonographic findings of breast cholesterol granuloma manifesting as an intracystic mass. The findings of this case report may help expand existing knowledge regarding differential diagnosis of intracystic breast masses, which are found on ultrasonographic examination.
Biopsy, Needle ; Breast Diseases/pathology/surgery/*ultrasonography ; *Cholesterol ; Diagnosis, Differential ; Female ; Granuloma, Foreign-Body/pathology/surgery/*ultrasonography ; Humans ; Mammography ; Middle Aged ; *Ultrasonography, Mammary

Actins ; metabolism ; Adult ; Breast Diseases ; metabolism ; pathology ; surgery ; Breast Neoplasms ; pathology ; Calcium-Binding Proteins ; metabolism ; Carcinoma ; pathology ; Diagnosis, Differential ; Fasciitis ; metabolism ; pathology ; surgery ; Female ; Fibroma ; pathology ; Fibrosarcoma ; pathology ; Follow-Up Studies ; Humans ; Microfilament Proteins ; metabolism ; Vimentin ; metabolism ; Young Adult

Breast Neoplasms ; pathology ; radiotherapy ; surgery ; Diagnosis, Differential ; Female ; Hemangiosarcoma ; etiology ; pathology ; surgery ; Humans ; Iatrogenic Disease ; Neoplasm Recurrence, Local ; Neoplasms, Radiation-Induced ; etiology ; pathology ; surgery ; Vascular Diseases ; etiology ; pathology ; surgery

Adenocarcinoma, Mucinous ; pathology ; Antigens, CD34 ; metabolism ; Breast ; metabolism ; pathology ; surgery ; Breast Diseases ; metabolism ; pathology ; surgery ; Breast Neoplasms ; pathology ; Diagnosis, Differential ; Female ; Fibroadenoma ; pathology ; Follow-Up Studies ; Humans ; Mastectomy ; Middle Aged ; Mucinoses ; metabolism ; pathology ; surgery ; Mucocele ; pathology ; S100 Proteins ; metabolism ; Vimentin ; metabolism

A tumoral pseudoangiomatous stromal hyperplasia (PASH) that causes huge breast enlargement is very rare. Only two cases of huge tumoral PASHs have been reported in the English medical literature. We report here on a surgically confirmed case of bilateral huge tumoral PASH in a 47-year-old woman, and we present the imaging and histopathology findings. We also review the relevant medical literature.
Angiomatosis/*pathology/surgery/ultrasonography ; Biopsy, Needle ; Breast/cytology/pathology/surgery ; Breast Diseases/*pathology/surgery/ultrasonography ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Female ; Gadolinium DTPA/diagnostic use ; Humans ; Hyperplasia ; Image Enhancement/methods ; Magnetic Resonance Imaging/methods ; Mammography/methods ; Middle Aged ; Stromal Cells/pathology

OBJECTIVETo study the clinical and pathologic features of granulomatous lobular mastitis (GLM).

METHODSSixty-eight cases of GLM were retrieved from the archival file. The clinical data and histologic features were retrospectively reviewed.

RESULTSSixty-eight patients presented with breast mass. Ulceration in overlying breast skin was seen in 9 cases. Most of the patients had history of breast feeding. None of them had evidence of specific infections involving the breast. The clinical and radiologic features mimicked malignancy. Histologically, GLM was characterized by the presence of non-necrotizing granulomas, usually admixed with neutrophils and associated with benign ductolobular units. The ductolobular architecture was still preserved. The duration of follow up ranged from 6 to 36 months. Four patients suffered from disease recurrence.

CONCLUSIONSGLM shows clinical and radiologic features reminiscent of breast cancer. Correct diagnosis requires histologic examination of the biopsy specimens.

Adult ; Breast Diseases ; pathology ; Breast Feeding ; adverse effects ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Granuloma ; microbiology ; pathology ; Granulomatous Mastitis ; etiology ; pathology ; surgery ; Humans ; Mastitis ; pathology ; Middle Aged ; Mycobacterium tuberculosis ; isolation & purification ; Plasma Cells ; pathology ; Recurrence ; Retrospective Studies ; Sarcoidosis ; pathology ; Young Adult

A 37-year-old female, who had received modified radical mastectomy for cancer of her right breast, presented with decreased visual acuity in the left eye after radiation therapy for the management of the metastasis to her right brain 14 months ago. After ocular examination, we diagnosed her as radiation retinopathy. At the time of the first visit, the corrected best visual acuity was 0.4 in the left eye, and fundus examination revealed cotton wool spots and cystoid macular edema (CME). The findings in the right eye were normal except for cotton wool spots in the superior major arch. Fluorescein angiography (FA) showed marked telangiectasia and microaneurysms in her left eye but tiny microaneurysms in her right eye. Subsequent optical coherent tomography (OCT) showed CME. We injected intravitreal triamcinolone acetonide (TA). Two weeks after treatment, the visual acuity was improved to 0.6 and the retinal thickness was decreased. Three months later, the visual acuity in the left eye was dropped to 0.3 due to the recurrence of CME, so we injected intravitreal TA again. Five months later, visual acuity was improved to 0.5 and OCT revealed the improvement of CME. The incidence of radiation retinopathy is higher in the side nearer to radiation, but careful radiation blocking is also required on the opposite side of irradiation site considering the possibility of radiation retinopathy and careful observation is required on both sides of the eyes when performing fundus examination.
Adult ; Brain Neoplasms/*radiotherapy/secondary ; Breast Neoplasms/pathology/radiotherapy/surgery ; Diagnosis, Differential ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Glucocorticoids/administration & dosage ; Humans ; Radiation Injuries/diagnosis/drug therapy/*etiology ; Retina/pathology/*radiation effects ; Retinal Diseases/diagnosis/drug therapy/*etiology ; Tomography, Optical Coherence ; Triamcinolone Acetonide/administration & dosage