High-frequency ultrasound (10–13 MHz) in inflammatory diseases of the breast☆

Abstract The role of high frequency ultrasound (10–13 MHz) in inflammatory disease of the breast is described. Forty-six patients with inflammatory breast problems were examined using both 10–13 and 7.5 MHz ultrasound; 39 patients also had mammography, 15 ultrasound-guided biopsy and 1 ductography. The diagnosis of inflammatory disease was confirmed by clinical and imaging follow-up only in 31, by cytology in 13 and at open surgical biopsy in 2. Diffuse mastitis imaged with 10–13 MHz ultrasound showed the following features: lymphatic involvement with (4 patients) or without (13 patients) a complex mass, ductal involvement with (1 patient) or without (4 patients) a complex mass, and ductal involvement associated with a complex mass and lymphangiectasia (1 patient). Focal mastitis imaged at 10–13 MHz demonstrated the following features: a complex predominantly solid mass (11 patients), a focal lesion with a predominantly fluid content (9 patients) and circumscribed ductal involvement with (1 patient) or without (2 patients) lymphangiectasia. Ultrasound imaging at 7.5 MHz failed to demonstrate lymphatic involvement in 15 of 19 patients and ductal involvement in all the patients. No difference was observed in the detection of axillary nodes at 7.5 MHz and 13 MHz. Ultrasound imaging at 7.5 MHz failed to identify focal solid lesions with a diameter of more than 10 mm in 2 of 6 patients. Ultrasound imaging at 7.5 MHz identified the nature of a solid mass in only 4 of 14 patients. We conclude that high frequency ultrasound (10–13 MHz) is effective, and more useful than conventional ultrasound at 7.5 MHz, in differentiating infection from lymphatic obstruction in patients with breast inflammation.