Analysis of Clinically Symptomatic Patients to Differentiate Inflammatory Breast Cancer from Mastitis in Asian Women
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Clinical and Demographic Data
2.3. Ultrasound Examination and Analysis
2.4. Histopathology Review
2.5. Statistical Analysis
3. Results
3.1. Clinical and Demographic Characteristics
3.2. Ultrasound Features
3.3. Pathological and Biopsy Results
3.4. Logistic Regression Analysis of Factors Associated with IBC
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Total | IBC | Mastitis | p-Value |
---|---|---|---|---|
Number of Patients | 101 | n = 14 (13.9%) | n = 87 (86.1%) | |
Age | ||||
(mean ± SD) | 39.5 ± 12.1 | 46.4 ± 11.4 | 38.4 ± 11.9 | 0.020 |
(median, IQR) | 37.0 (32.0–44.0) | 44.5 (39.8–58.3) | 35.0 (32.0–4.0) | |
≥40 years | 34 (33.7%) | 11 (78.6%) | 23 (26.4%) | <0.001 |
<40 years | 67 (66.3%) | 3 (21.4%) | 64 (73.6%) | |
BMI | ||||
(mean ± SD) | 25.1 ± 4.5 | 28.8 ± 3.9 | 24.4 ± 4.3 | 0.009 |
Underweight: BMI < 18.5 | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | 0.043 |
Normal weight: BMI 18.5–22.9 | 20 (39.2%) | 0 (0.0%) | 20 (46.5%) | |
Overweight: BMI 23–24.9 | 5(9.8%) | 1(12.5%) | 4 (9.3%) | |
Obesity: BMI ≥ 25 | 26 (51.0%) | 7(87.5%) | 19 (44.2%) | |
Normal weight | 20 (39.2%) | 0(0.0%) | 20 (46.5%) | 0.012 |
Overweight + Obesity | 31 (60.8%) | 8 (100.0%) | 23 (53.5%) | |
Menopausal Status | ||||
Premenopause | 82 (81.2%) | 6 (42.9%) | 76 (87.4%) | <0.0001 |
Postmenopause | 19 (18.8%) | 8 (57.1%) | 11 (12.6%) | |
During Pregnancy/Lactation | ||||
Yes | 23 (22.8%) | 2 (14.3%) | 21 (24.1%) | 0.333 |
No | 78 (77.2%) | 12 (85.7%) | 66 (75.9%) | |
Symptom Onset (days ago) | ||||
(mean ± SD) | 16.7 ± 17.0 | 37.7 ± 21.3 | 12.7 ± 12.8 | 0.002 |
(median, IQR) | 14.0 (7.0–30.0) | 60.0 (18.8–60.0) | 10.0 (5.0–20.0) | |
Localized Symptoms | ||||
Erythema | 38 (37.6%) | 5 (35.7%) | 33 (37.9%) | 0.562 |
Swelling | 19 (18.8%) | 7 (50.0%) | 12 (13.8%) | 0.004 |
Skin change | 26 (25.7%) | 3 (21.4%) | 23 (26.4%) | 0.489 |
Warmth | 24 (23.8%) | 2 (14.3%) | 22 (25.3%) | 0.300 |
Mass | 48 (47.5%) | 7 (50.0%) | 41 (47.1%) | 0.534 |
Pain/discomfort | 48 (47.5%) | 6 (42.9%) | 42 (48.3%) | 0.466 |
Number of Localized Symptoms | ||||
(mean ± SD) | 2.0 ± 0.8 | 2.1 ± 0.9 | 2.0 ± 0.8 | 0.515 |
(median, IQR) | 2.0 (1.0–3.0) | 2.0 (1.8–3.0) | 2.0 (1.0–3.0) | |
Systemic Symptoms | ||||
Yes | 7 (6.9%) | 1 (7.1%) | 6 (6.9%) | 0.660 |
No | 94 (93.1%) | 13 (92.9%) | 81 (93.1%) | |
Previous Mastitis History | ||||
Yes | 34 (33.7%) | 1 (7.1%) | 33 (37.9%) | 0.019 |
No | 67 (66.3%) | 13 (92.9%) | 54 (62.1%) | |
Personal History of Cancer | ||||
Yes | 1 (1.0%) | 0 (0.0%) | 1 (1.1%) | 0.861 |
No | 100 (99.0%) | 14 (100.0%) | 86 (98.9%) | |
Family History of Breast Cancer | ||||
Yes | 3 (3.0%) | 0(0.0%) | 3 (3.4%) | 0.636 |
No | 98 (97.0%) | 14 (100.0%) | 84 (96.6%) | |
Underlying Diseases | ||||
DM/metabolic syndrome | 18 (17.8%) | 2 (14.3%) | 16 (18.4%) | 0.646 |
Immunocompromised | 4 (4.0%) | 0 (0.0%) | 4 (4.6%) | |
No | 79 (78.2%) | 12 (85.7%) | 67 (77.0%) | |
Mental disorder | ||||
Yes | 8 (7.9%) | 1 (7.1%) | 7 (8.0%) | 0.694 |
No | 93 (92.1%) | 13 (92.9%) | 80 (92.0%) | |
Drinking | ||||
Yes | 10 (13.2%) | 0 (0.0%) | 10 (16.1%) | 0.113 |
No | 66 (86.6%) | 14 (100.0%) | 52 (83.9%) | |
Smoking | ||||
Yes | 4 (5.3%) | 0(0.0%) | 4 (6.5%) | 0.435 |
No | 72 (94.7%) | 14 (100.0%) | 58 (93.5%) |
Variables | Total | IBC | Mastitis | p-Value |
---|---|---|---|---|
Bilaterality | ||||
Right | 50 (49.5%) | 8 (57.1%) | 42 (48.3%) | 0.780 |
Left | 50 (49.5%) | 6 (42.9%) | 44 (50.6%) | |
Both | 1 (1.0%) | 0 (0.0%) | 1 (1.1%) | |
Lesion Type | ||||
Mass | 31 (30.7%) | 3 (21.4%) | 28 (32.2%) | 0.319 |
Non-mass | 70 (69.3%) | 11 (78.6%) | 59 (67.8%) | |
Lesion Location | ||||
Central | 41 (41.8%) | 8 (61.5%) | 33 (38.8%) | 0.107 |
Peripheral | 57 (58.2%) | 5 (38.5%) | 52 (61.2%) | |
Multiplicity | ||||
Single | 75 (74.3%) | 11 (78.6%) | 64 (73.6%) | 0.489 |
Multiple | 26 (25.7%) | 3 (21.4%) | 23 (26.4%) | |
Echogenicity | ||||
Hypoechoic | 74 (74.0%) | 10 (71.4%) | 64 (73.6%) | 0.521 |
Isoechoic | 26 (26.0%) | 4 (28.6%) | 22 (25.3%) | |
Hyperechoic | 1 (1.0%) | 0 (0.0%) | 1 (1.1%) | |
Echo pattern | ||||
Homogeneous | 38 (37.6%) | 4 (28.6%) | 34 (39.1%) | 0.330 |
Heterogeneous | 63 (62.4%) | 10 (71.4%) | 53 (60.9%) | |
Size | ||||
<1/2 | 61 (60.4%) | 5 (35.7%) | 56 (64.4%) | 0.001 |
≥1/2 | 36 (35.6%) | 6 (42.9%) | 30 (34.5%) | |
Whole breast | 4 (4.0%) | 3 (21.4%) | 1 (25.0%) | |
Internal Change | ||||
Cystic/Necrotic | 30 (29.7%) | 1 (7.1%) | 29 (33.3%) | 0.039 |
No | 71 (70.3%) | 13 (92.9%) | 58 (66.7%) | |
Vascularity | ||||
Minimal/Mild | 64 (63.4%) | 12 (85.7%) | 52 (59.8%) | 0.150 |
Moderate/Severe | 28 (27.7%) | 2 (14.3%) | 26 (29.9%) | |
No | 9 (8.9%) | 0 (0.0%) | 9 (10.3%) | |
Skin Thickening | ||||
Yes | 83 (82.2%) | 13 (92.9%) | 70 (80.5%) | |
No | 18 (17.8%) | 1 (7.1%) | 17 (19.5%) | 0.237 |
Parenchymal Edema | ||||
Yes | 89 (88.1%) | 14 (100.0%) | 75 (86.2%) | 0.149 |
No | 12 (11.9%) | 0 (0.0%) | 12 (13.8%) | |
Nipple Inversion | ||||
Yes | 17 (16.8%) | 4 (28.6%) | 13 (14.9%) | 0.185 |
No | 84 (83.2%) | 10 (71.4%) | 74 (85.1%) | |
Calcifications | ||||
Yes | 3 (3.0%) | 1 (7.1%) | 2 (2.3%) | 0.364 |
No | 98 (97.0%) | 13 (92.9%) | 85 (97.7%) | |
Ductal Change | ||||
Yes | 33 (32.7%) | 5 (35.7%) | 28 (32.2%) | 0.507 |
No | 68 (67.3%) | 9 (64.3%) | 59 (67.8%) | |
Lymphadenopathy | ||||
Yes | 36 (35.6%) | 8 (57.1%) | 28 (32.2%) | 0.136 |
Equivocal | 42 (41.6%) | 5 (35.7%) | 37 (42.5%) | |
No | 23 (22.8%) | 1 (7.1%) | 22 (25.3%) |
Variables | Frequency (%) |
---|---|
Biopsy-proven benign disease suggesting mastitis (n = 62) | |
Chronic granulomatous inflammation | 31 (50.0%) |
Chronic granulomatous inflammation and abscess formation | 11 (17.7%) |
Inflammation and abscess formation | 12 (19.4%) |
Inflammation | 8 (12.9%) |
Biopsy-proven malignancy suggesting IBC (n = 14) | |
Invasive (n = 13) | |
Invasive ductal carcinoma | 11 (78.6%) |
Microinvasive ductal carcinoma | 1 (7.1%) |
Invasive lobular carcinoma | 1 (7.1%) |
Non-invasive (n = 1) | |
Ducal carcinoma in situ | 1 (7.1%) |
Variables | Crude OR | 95% CI | Adjusted OR | 95% CI | p-Value |
---|---|---|---|---|---|
Age | |||||
(mean ± SD) | 1.05 | 1.01–1.09 | |||
≥40 years | 10.20 | 2.61–39.86 | 2.76 | 0.25–30.46 | 0.407 |
<40 years | ref. = 1 | ref. = 1 | |||
BMI | |||||
(mean ± SD) | 1.24 | 1.04–1.49 | |||
Normal weight | ref. = 1 | ||||
Overweight + Obesity | 999.99 | 0.01–999.99 | |||
Menopausal Status | |||||
Premenopause | ref. = 1 | ref. = 1 | |||
Postmenopause | 9.21 | 2.69–31.61 | 6.48 | 0.40–104.99 | 0.189 |
Symptom Onset (days ago) | |||||
(mean ± SD) | 1.07 | 1.03–1.11 | 1.07 | 1.02–1.14 | 0.014 |
Localized Symptoms | |||||
Swelling | 6.25 | 1.86–21.01 | 15.24 | 1.68–138.69 | 0.016 |
Previous Mastitis History | |||||
Yes | ref. = 1 | ||||
No | 7.94 | 0.99–63.54 | |||
Size (US) | |||||
<1/2 | ref. = 1 | ref. = 1 | |||
≥1/2 | 2.24 | 0.63–7.95 | 4.49 | 0.52–38.77 | 0.761 |
Whole breast | 33.60 | 2.93–385.91 | 43.09 | 0.71–999.99 | 0.129 |
Internal Change (US) | |||||
Cystic/Necrotic | ref. = 1 | ||||
No | 6.90 | 0.81–52.63 | |||
H-W Chisq * | 1.48 | 0.983 |
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Mun, H.S.; Oh, H.Y. Analysis of Clinically Symptomatic Patients to Differentiate Inflammatory Breast Cancer from Mastitis in Asian Women. Life 2025, 15, 5. https://doi.org/10.3390/life15010005
Mun HS, Oh HY. Analysis of Clinically Symptomatic Patients to Differentiate Inflammatory Breast Cancer from Mastitis in Asian Women. Life. 2025; 15(1):5. https://doi.org/10.3390/life15010005
Chicago/Turabian StyleMun, Han Song, and Ha Yeun Oh. 2025. "Analysis of Clinically Symptomatic Patients to Differentiate Inflammatory Breast Cancer from Mastitis in Asian Women" Life 15, no. 1: 5. https://doi.org/10.3390/life15010005
APA StyleMun, H. S., & Oh, H. Y. (2025). Analysis of Clinically Symptomatic Patients to Differentiate Inflammatory Breast Cancer from Mastitis in Asian Women. Life, 15(1), 5. https://doi.org/10.3390/life15010005