Lupus mastitis mimicking a breast tumor

Area of Science:

• Rheumatology
• Dermatology
• Pathology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
• Lupus mastitis is an uncommon manifestation of SLE, presenting as breast-limited lupus panniculitis.
• It rarely occurs in patients with established SLE.

Observation:

• A 33-year-old woman with SLE presented with acute right breast pain, tenderness, and erythema.
• Imaging suggested a breast tumor, and clinical examination revealed an inflammatory mass.
• Elevated anti-dsDNA antibodies, white blood cell count, and ESR, with impaired renal function, were noted.

Findings:

• Core needle biopsy was initially considered, but surgical excision and biopsy were performed.
• Histopathology confirmed lupus mastitis.
• The case highlights the diagnostic challenge posed by lupus mastitis presenting as a breast lump.

Implications:

• Lupus mastitis can present as a breast lump, mimicking malignancy.
• Early recognition and appropriate biopsy are crucial for accurate diagnosis.
• This rare condition requires a multidisciplinary approach involving clinicians, radiologists, and pathologists.