[Advances in predisposing factors and pathogenesis of granulomatous lobular mastitis]

Granulomatous lobular mastitis (GLM) is a chronic inflammatory breast disease of unknown aetiology, characterised by granulomatous inflammation centred on the mammary lobules. Clinically, it presents with breast redness, swelling, and ulceration, with a protracted course prone to recurrence. Its development is closely associated with multiple factors including milk stasis, hyperprolactinemia, ductal injury, and microbial infection. The pathogenesis remains incompletely elucidated, with various hypotheses proposed such as autoimmune responses, delayed-type hypersensitivity, and autoinflammatory reactions. Key mechanisms involve abnormal activation of cellular and humoral immunity, release of multiple inflammatory cytokines, and activation of signalling pathways including NF-κB and PI3K/AKT/mTOR. This article systematically reviews relevant literature spanning nearly five decades, summarising the evolution of GLM definitions, predisposing factors, and pathogenesis. It aims to establish a theoretical foundation for future molecular subtyping, immunological target exploration, multicentre studies, and the advancement of precision prevention and treatment for GLM.