Evaluation of Lesion Sizes, Quadrant Distributions and Axillary Lymph Node Characteristics in Idiopathic Granulomatous Mastitis

Objective:The purpose of this study was to determine the distribution and predilection of lesions within breast quadrants and to investigate the relationship between lesions and axillary lymph node size. Methods:The study included 46 patients with histopathologically proven granulomatous mastitis who underwent dynamic contrast-enhanced magnetic resonance imaging at 3.0 T. The position relative to the areola was used to determine which quadrants were affected.Volumetric size measurements of lesions and axillary lymph nodes were obtained using multiplanar reformation imaging.Results: Single quadrant invovelment was seen in 8 (17.4%) patients and there were 8 (17.4%) patients with all quadrants involved.The numbers of patients in the upper outer, upper inner, lower outer, and lower inner quadrants were 24 (52.2%), 26 (56.5%), 24 (52.2%), and 23 (50%), respectively.Lesion sizes ranged from 2.03 to 474.17 cm [mean standard deviation (SD): 59.10 95.38 cm].Lymph node cortex thickness ranged from 2.6 to 12.4 mm, with a mean SD of 5.51 2.08 mm.No significant correlation was found between lesion size and any of the following lymph node measurements: long-axis length, short-axis length, or cortical thickness (P > 0.05). Conclusion:A Broad spectrum of lesion appearances, sizes, and axillary lymphadenopathies may pose a diagnostic challenge in idiopathic granulomatous mastitis (IGM).Our study identified findings that will aid in the diagnosis of IGM.We have shown that no particular breast quadrant is more affected in IGM.Also, multiregional, multicentric, or widespread disease is not uncommon.Lymphadenopathies with suspicious features frequently accompany the disease.