Microwave Ablation for Granulomatous Lobular Mastitis: A Narrative Review

Granulomatous lobular mastitis (GLM) is a rare, chronic, and benign inflammatory breast disease predominantly affecting women of reproductive age. It is clinically characterized by breast masses, pain, erythema, and the potential development of abscesses and fistulas. The etiology remains complex, involving autoimmune responses, bacterial infections, and hormonal imbalances. Currently, there is no standardized consensus on the optimal management of GLM. Conventional treatment modalities, including systemic corticosteroids, immunosuppressants, and surgical excision, are frequently constrained by elevated recurrence rates, poor aesthetic outcomes, and severe systemic adverse effects. Consequently, there is an urgent clinical need for alternative, minimally invasive interventions. Microwave ablation (MWA) has emerged as a novel therapeutic approach that utilizes electromagnetic energy to induce localized coagulative necrosis of pathological tissues. This narrative review synthesizes recent clinical research to evaluate the potential efficacy and safety of MWA for treating GLM. Current preliminary evidence suggests that ultrasound-guided MWA may reduce the recurrence rate of GLM while achieving promising clinical and pathological remission rates. Furthermore, compared to traditional surgical and pharmacological therapies, MWA may offer advantages, including the preservation of breast tissue, improved cosmetic outcomes, reduced postoperative complications, and shorter recovery times. However, it is crucial to note that the current evidence base is limited by a small number of predominantly retrospective studies, a lack of long-term comparative data, and limited geographic diversity. Despite the necessity for specialized equipment, advanced operator expertise, and careful patient selection, MWA may serve as a promising and well-tolerated treatment option for managing GLM.