[Non-puerperal mastitis. Etiology, clinical aspects and therapy]

Area of Science:

• Medical Sciences
• Clinical Medicine
• Pathology

Background:

• Non-puerperal mastitis affects women of various ages, with bacterial infections near the areola being common.
• Increased mammary gland secretory activity (galactorrhea, mastodynia) is frequently observed alongside mastitis.
• Malignant neoplasm was ruled out in all diagnosed cases.

Purpose of the Study:

• To investigate the causes, treatment outcomes, and recurrence patterns of non-puerperal mastitis.
• To evaluate the role of increased mammary secretion in mastitis pathogenesis.
• To assess the efficacy of prolactin-lowering therapy in managing mastitis and preventing recurrence.

Main Methods:

• Retrospective analysis of 79 non-puerperal mastitis cases diagnosed between 1974-1984.
• Identification of causative organisms, including Staphylococcus aureus, coagulase-negative staphylococcus, and anaerobic bacteria.
• Treatment modalities included physical measures, antibiotics, and bromocriptine, with a focus on prolactin-lowering therapy.

Main Results:

• Bacterial infection (40%) and abacterial inflammation (29%) were primary findings. Staphylococcus aureus and coagulase-negative staphylococcus were the most common pathogens.
• Abscesses developed in 34 patients, and 28 experienced recurrences. Prophylactic bromocriptine treatment in 22 patients resulted in only two recurrences.
• Increased alveolar secretion was identified as a significant factor in the pathogenesis of both bacterial and abacterial mastitis.

Conclusions:

• Prolactin-lowering treatment, such as bromocriptine, is a viable therapeutic option for abacterial mastitis and can be combined with antibiotics for bacterial mastitis.
• Long-term reduction of peripheral prolactin levels appears to be an effective strategy for preventing mastitis recurrence.
• Managing increased mammary secretion is crucial for the successful treatment and prevention of non-puerperal mastitis.