Cancer mammaire inflammatoire et abces non puerperaux: Diagnostic et suivi par mammographie, echographie et Doppler couleur

Purpose: To investigate the role of mammography, B-mode and color Doppler ultrasonography in the diagnosis and treatment of abscessual breast cancer and non-puerperal abscesses. Methods and materials: We reviewed the exams of 10 women with abscessual breast cancer (2) and non-puerperal abscesses (8). All patients underwent physical examination, mammography, B- mode and color Doppler ultrasonography (US): seven collections (6 abscesses and 1 abscessual cancer) were drained under US guidance: US structure and vascularization changes in the lesions were also investigated during treatment. Results: Ultrasonography depicted abscessual collections and permitted to assess their size, features and posttreatment changes; moreover, US was useful for drainage, especially of multilobed abscesses, and essential to time biopsy. Color Doppler showed decreased vascularization and changes in flow characteristics in seven non-puerperal abscesses with positive response to antibiotic treatment, while, in one patient not responding to treatment, vascularization remained rich, with unchanged spectral characteristics. Mammography and B-mode and color Doppler US failed to make the differential diagnosis between abscessual neoplasms and non-puerperal abscesses. Conclusion: Present-day imaging techniques are inadequate to make an unquestionable differential diagnosis of abscessual neoplasms and non- puerperal abscesses. Nevertheless, B-mode US is the method of choice to guide drainage and an essential tool to time biopsy; color Doppler is useful to monitor treatment response.