E1687. Manifestation of Systemic Disease in the Breast
  1. Alex Chung; University of California, Los Angeles
  2. Parsa Asachi; University of California, Los Angeles
  3. Tiffany Chan; University of California, Los Angeles
  4. Revana Lukman; University of California, Los Angeles
  5. Anne Hoyt; University of California, Los Angeles
  6. Lucy Chow; University of California, Los Angeles
A variety of systemic diseases can manifest in the breast with known imaging findings on mammogram, ultrasound and MRI. Knowledge of full spectrum of imaging characteristics of systemic disease as they present in the breast can help the radiologist differentiate these entities from primary breast malignancy and help guide appropriate management.

Educational Goals / Teaching Points
• Describe imaging manifestation of systemic diseases that occur in the breast including the vasculature, lymphatics, skin, and parenchyma structures. • Discuss the systemic diseases that can mimic primary breast malignancy. • Review the clinical features, diagnosis and management of systemic diseases that impact the breast.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Systemic diseases that affect the breast will be discussed with relevant imaging examples as follows but not limited to: • Inflammatory: - Rheumatoid arthritis (and gold therapy) - Systemic lupus erythematosus - Dermatomyositis / polymyositis - Scleroderma - Psoriatic arthritis - Polyangiitis with granulomatosis (Wegener granulomatosis) - Churg-Strauss syndrome - Crohn disease • Malignant: - Metastases - Lymphoma - Leukemia - Multiple myeloma / plasmacytoma - Sarcoma/Rhabdomyosarcoma - Schwanomma/peripheral nerve sheath tumor - Radiation-induced changes • Endocrinopathic: - Hyperparathyroidism - Diabetes - Lactating adenoma • Cutaneous: - Neurofibromatosis - Steacystoma multiplex - Necrobiotic xanthogranulomatosis - Pseudoxanthoma elasticum (PXE) - Ehlers-Danlos syndrome • Infectious: - Mycobacterium - Bacteria - Parasites - Fungi - Viruses • Cardiovascular: - Congestive heart failure - Superior vena cava syndrome - Coronary arterial disease - Venous engorgement / thrombosis (Mondor disease) • Other: - Sarcoidosis - Cowden Syndrome - Amyloidosis - Galactocele - Fat necrosis

• Various systemic diseases can present as abnormalities in breast imaging. • Diseases affecting the breast can originate from almost any organ system, and corresponding imaging abnormalities can be vascular, lymphatic, cutaneous, or parenchymal in nature. • It is important for a radiologist to be aware of these diseases and corresponding breast imaging findings in order to identify the systemic diseases and make appropriate follow-up recommendations.