Diagnostic considerations in suspected diffuse breast cancer

Diagnosis of diffuse changes in the breast without clearly identifiable mass is a challenging task. Differential diagnosis should include cancer, fibrosis, fibroadenomatoid mastopathy and mastitis of various etiologies. The results of breast ultrasound, mammography, computed tomography and magnetic resonance imaging can be inconclusive. Thorough examination of regional lymph nodes must be performed: presence of metastases in them, combined with clinical changes in the breast, confirms diffuse breast cancer. Any suspicious areas are subject to a biopsy. In a clinical presentation suggestive of a diffuse breast cancer, an accurate diagnosis should be sought in view of severe consequences of errors and delays in diagnosis.