{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:41:29Z","timestamp":1793814089977,"version":"4.6.1"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: To compare and determine discriminative magnetic resonance imaging (MRI) findings of idiopathic granulomatous mastitis (IGM) and breast cancer (BC) that present as non-mass enhancement. Materials and Methods: This retrospective study includes 68 IGM and 75 BC cases that presented with non-mass enhancement on breast MRI. All patients with a previous history of breast surgery, radiotherapy, or chemotherapy due to BC or a previous history of mastitis were excluded. On MRI images, presence of architectural distortion skin thickening, edema, hyperintense ducts containing protein, dilated fat-containing ducts and axillary adenopathies were noted. Cysts with enhancing walls, lesion size, lesion location, fistulas, distribution, internal enhancement pattern and kinetic features of non-mass enhancement were recorded. Apparent diffusion coefficient (ADC) values were calculated. Pearson chi-square test, Fisher\u2019s exact test, independent t test and Mann\u2013Whitney U test were used as needed for statistical analysis and comparison. Multivariate logistic regression model was used to determine the independent predictors. Results: IGM patients were significantly younger than BC patients (p &lt; 0.001). Cysts with thin (p &lt; 0.05) or thick walls (p = 0.001), multiple cystic lesions, (p &lt; 0.001), cystic lesions draining to the skin (p &lt; 0.001), and skin fistulas (p &lt; 0.05) were detected more often in IGM. Central (p &lt; 0.05) and periareolar (p &lt; 0.001) location and focal skin thickening (p &lt; 0.05) were significantly more common in IGM. Architectural distortion (p = 0.001) and diffuse skin thickening (p &lt; 0.05) were associated with BC. Multiple regional distribution was more common in IGM, whereas diffuse distribution and clumped enhancement were more common in BC (p &lt; 0.05). In kinetic analysis, persistent enhancement was more common in IGM, whereas plateau and wash-out types were more common in BC (p &lt; 0.001). Independent predictors for BC were age, diffuse skin thickening and kinetic curve types. There was no significant difference in the diffusion characteristics. Based on these findings, MRI had a sensitivity, specificity and accuracy of 88%, 67.65%, and 78.32%, respectively, in differentiating IGM from BC. Conclusions: In conclusion, for non-mass enhancement, MRI can rule out malignancy with a considerably high sensitivity; however, specificity is still low, as many IGM patients have overlapping findings. Final diagnosis should be complemented with histopathology whenever necessary.<\/jats:p>","DOI":"10.3390\/diagnostics13081475","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T01:42:39Z","timestamp":1681954959000},"page":"1475","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Idiopathic Granulomatous Mastitis or Breast Cancer? A Comparative MRI Study in Patients Presenting with Non-Mass Enhancement"],"prefix":"10.3390","volume":"13","author":[{"given":"Fatma Nur","family":"Soylu Boy","sequence":"first","affiliation":[{"name":"Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, 34758 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6821-8696","authenticated-orcid":false,"given":"Gul","family":"Esen Icten","sequence":"additional","affiliation":[{"name":"Senology Research Institute, Acibadem Mehmet Ali Ayd\u0131nlar University, 34457 Istanbul, Turkey"},{"name":"Department of Radiology, School of Medicine, Acibadem Mehmet Ali Ayd\u0131nlar University, 34457 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1590-5382","authenticated-orcid":false,"given":"Yasemin","family":"Kayadibi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iksan","family":"Tasdelen","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Fatih Sultan Mehmet Training and Research Hospital, 34758 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9227-9074","authenticated-orcid":false,"given":"Dolunay","family":"Alver","sequence":"additional","affiliation":[{"name":"Department of Radiology, Fatih Sultan Mehmet Training and Research Hospital, 34758 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1111\/j.1075-122X.2004.21336.x","article-title":"Idiopathic granulomatous mastitis: Time to avoid unnecessary mastectomies","volume":"10","author":"Yaghan","year":"2004","journal-title":"Breast J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0002-9343(92)90688-8","article-title":"Diagnosis and treatment of granulomatous mastitis","volume":"93","author":"Jorgensen","year":"1992","journal-title":"Am. 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