REVIEW ARTICLE
BEYOND MASTITIS: MULTICENTRIC BREAST ABSCESS OF THE RIGHT BREAST DIAGNOSED BY MULTIMODAL IMAGING

UDK: 618.19-002.3-073.763.5

www.doi.org/10.67214/y7n2n013

Nikolova S.1,2

¹University Institute of Radiology, Skopje, Republic of North Macedonia

2Faculty of Medicine, “Ss Cyril and Methodius” University, Skopje, Republic of North Macedonia

Abstract

Introduction: Breast abscess is a known complication of mastitis, however multicentric involvement in non-lactating patients is uncommon and may closely mimic malignancy, creating a diagnostic challenge and often necessitating advanced imaging.

Case Presentation: We report the case of a 28-year-old patient who was referred with a clinical diagnosis of right-sided mastitis following initial surgical evaluation. Ultrasound examination demonstrated a well-defined hypoechoic collection containing dense fluid, associated with a fistulous tract extending toward the para-mammary region, as well as findings suggestive of abscess formation. Given the complexity of the presentation, further evaluation with breast magnetic resonance imaging was performed. MRI revealed multiple multicentric lesions within the right breast, characterized by low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and peripheral rim enhancement following contrast administration, findings that are consistent with multicentric breast abscesses. No suspicious solid enhancing components were identified.

Conclusion: This case highlights the importance of a multimodal imaging approach in the assessment of atypical or extensive breast infections. While ultrasound remains the first-line modality for detection and guidance of intervention, MRI provides superior delineation of disease extent, identification of multicentric involvement, and improved differentiation from malignancy. Accurate imaging interpretation is essential for appropriate clinical management, avoiding unnecessary invasive procedures, and ensuring timely and targeted treatment.

Keywords: breast abscess; breast infection; magnetic resonance imaging; mastitis; ultrasound.

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