A

Clinical Problem

Breast Inflammation

A1

Ref No. in MBUR4 (if any)

J13

A2

Section in MBUR4

Breast disease

B

Search strategy: databases used; period; MeSH headings; other key words.

Medline 1966-June 2001, EMBASE 1988-2001, diagnostic imaging, breast disease, abscess, radiography, ultrasonography

C

Search results: no. found;

no. used.

37 found, 2 used

D

Reference numbers of cited references in attached master list.

J13 1,2

E

Summarised results from each of the cited references

Crowe et al (J13 1) reviewed records of 21 women having imaging within 48 hours of presenting with breast inflammation. 63% of mammograms were abnormal. Diffuse skin thickening, oedema and dense lymph nodes suggest unusual infection or malignancy. All 11 ultrasounds showed heterogeneous masses with internal echoes, 5 of these inpatients with normal mammograms. Muttarak (J13 2) reports mammography and ultrasound in 20 abscesses, the combination allowed recognition of infection and helped to exclude malignancy.

F

Statement (= the conclusion drawn from E)

Mammography helps to diagnose or exclude malignancy when there is clinical doubt, Ultrasound is the examination of first choice and can guide drainage.

G

Evidence level of F classified I - IV

3

H

Investigation

Mammography

I

Recommendation *

Specialised examination

J

Grade of Recommendation

A - C

C

K

Comment (if any) to go in booklet version of MBUR5

L

Any other comments on this problem (e.g. caveats; suggestions for research or systematic review; cost or opportunity cost; users' views.

Ros Given-Wilson