Granulomatous mastitis: a case series

Area of Science:

• Breast pathology
• Inflammatory diseases
• Surgical oncology

Background:

• Granulomatous mastitis (GM) is a rare, chronic inflammatory condition affecting the breast.
• It typically presents in women of reproductive age, often non-lactating.
• GM can clinically mimic other serious breast conditions such as tuberculosis and breast cancer.

Purpose of the Study:

• To elucidate the clinical presentation and management strategies for granulomatous mastitis.
• To differentiate GM from other breast pathologies based on clinical and diagnostic findings.
• To evaluate treatment outcomes and recurrence rates in patients with GM.

Main Methods:

• A retrospective case study of histopathologically diagnosed granulomatous mastitis.
• Data collection included patient history, clinical examination, and diagnostic imaging (ultrasound, mammography, FNAC).
• Initial treatment involved antibiotics and corticosteroids, with surgical excision for recurrent cases.

Main Results:

• The study included 22 patients with a mean age of 37.6 years; 82% were non-lactating.
• Clinical presentations varied, including painful/painless lumps and discharging sinuses.
• Differential diagnoses included chronic mastitis (40.9%), breast tuberculosis (36.3%), and malignancy (22.7%). Mammography was often inconclusive.

Conclusions:

• Granulomatous mastitis is an uncommon inflammatory breast disease with a clinical presentation that can mimic malignancy or tuberculosis.
• While mammography may be non-conclusive, histopathology confirms the diagnosis.
• Management involves a short course of steroids and antibiotics, with surgical excision for recurrent disease, alongside close surveillance.