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The Breast Journal 2024Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory disorder of the breast that is often underrecognized. The exact etiology and pathophysiology are... (Review)
Review
Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory disorder of the breast that is often underrecognized. The exact etiology and pathophysiology are unknown, but milk stasis is felt to play a role. Classically, this condition is noninfectious, but many cases are noted to be associated with species. Most patients affected are parous women with a mean age of 35, and many have breastfed within five years of diagnosis. Patients typically present with a painful mass and symptoms of inflammation, and these features can sometimes mimic breast cancer. Biopsy is needed to make a definitive diagnosis, and noncaseating granulomas are found on core biopsy. Many patients have a waxing and waning course over a period of six months to two years. Goal of treatment is to avoid surgery given poor wound healing, high risk of recurrence, and poor cosmetic outcomes. Medical treatment is preferred and includes observation, antibiotics, steroids, and immune modulators such as methotrexate. In more recent years, topical and intralesional steroids have become the treatment of choice, with similar outcomes to oral steroids.
Topics: Female; Humans; Adult; Granulomatous Mastitis; Breast Neoplasms; Neoplasm Recurrence, Local; Breast; Steroids
PubMed: 38304866
DOI: 10.1155/2024/6693720 -
Ugeskrift For Laeger Oct 2021Granulomatous mastitis (GM) is a quite rare inflammatory condition of the breast with varying clinical presentations and microbiological findings. Having excluded... (Review)
Review
Granulomatous mastitis (GM) is a quite rare inflammatory condition of the breast with varying clinical presentations and microbiological findings. Having excluded specific diseases connected with GM, a group of idiopathic GM (IGM) remains including a special form presenting with multiple small cysts named cystic neutrophil GM (CNGM). The aetiology is unknown, and clinical investigation methods as well as treatment options are controversial. The purpose of this review is to describe diagnostic considerations and controversies in the treatment of IGM and CNGM.
Topics: Breast; Cysts; Female; Granulomatous Mastitis; Humans; Neutrophils
PubMed: 34761745
DOI: No ID Found -
Reumatologia Clinica May 2022
Topics: Diagnosis, Differential; Female; Humans; Mastitis
PubMed: 35568445
DOI: 10.1016/j.reumae.2021.05.006 -
The Journal of the American Osteopathic... Dec 2017Breast masses and nipple discharge are common symptoms that lead women to seek medical care. Many of the findings on subsequent examination are benign. When evaluating a... (Review)
Review
Breast masses and nipple discharge are common symptoms that lead women to seek medical care. Many of the findings on subsequent examination are benign. When evaluating a patient who presents with breast masses or nipple discharge, it is useful to take a holistic approach to evaluating the patient, including a detailed history, structural and directed physical examination, and, if indicated, laboratory studies, diagnostic imaging, and biopsy. The goal of this review is to assist physicians in understanding the evaluation, diagnosis, and management of benign breast conditions.
Topics: Breast; Breast Diseases; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Mastitis; Nipple Discharge
PubMed: 29181518
DOI: 10.7556/jaoa.2017.147 -
Tidsskrift For Den Norske Laegeforening... Jun 2024A young woman experienced pain and swelling in a non-lactating breast. The culture test result showed an unusual microbe, which is increasingly prevalent in Norway and...
A young woman experienced pain and swelling in a non-lactating breast. The culture test result showed an unusual microbe, which is increasingly prevalent in Norway and internationally.
Topics: Humans; Female; Gonorrhea; Neisseria gonorrhoeae; Anti-Bacterial Agents; Mastitis; Adult; Young Adult
PubMed: 38832624
DOI: 10.4045/tidsskr.23.0768 -
Turk Patoloji Dergisi 2022Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of...
OBJECTIVE
Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of GM cases, diagnostic clues for specific and idiopathic etiologies, the difficulties in evaluating trucut biopsies, and the results of different therapeutic approaches.
MATERIAL AND METHOD
We retrospectively analysed the clinical, radiological and morphological features of 114 GM cases diagnosed with fine needle aspiration, and trucut, incisional, and excisional biopsy.
RESULTS
The mean age was 35.8. Only eight cases were older than 45 years. Bilateral involvement was observed in 4 (3.5%) cases. The most common clinical symptoms were breast mass/abscesses, tenderness, and skin changes. Microbiological culture was positive in 4 cases for gram-positive bacteria. Only 3 cases showed a positive tuberculin/PCR test for tuberculosis. The major USG finding was a hypoechoic well-defined or ill-defined mass/abscess; MRI finding was heterogeneous non-mass contrast enhancement. Cases diagnosed with cytology (35 cases) did not have breast malignancy either in their history or clinical follow up period. Fine needle aspiration cytology materials revealed epitheloid granulomas mixed with neutrophils, lymphocytes accompanied by giant cells, and suppurative necrosis. Histopathological reevaluation of 65 trucut/incisional/ excisional biopsies revealed granuloma formation in 65 (100%), Langhans type giant cells in 59 (90.7%), microabscess formation in 41 (63%), caseous necrosis in 1 (1.5%), neutrophilic cysts in 30 (46.1%), eosinophilic infiltration in 48 (73.8%), interlobular inflammation in 14 (21.5%), fat necrosis in 5 (7.6%), ductal ectasia in 6 (9.2%), and lactational changes in 4 (6.1%) cases. Granulomas were lobulocentric in 58 cases, foreign body type/fat necrosis-related in 6 case, and periductular in 1 case. Cystic neutrophilic granulomatous mastitis was observed in one case. We also evaluated the histochemical stains of these 65 biopsies. Only one sample was positive for acido-resistant bacilli (ARB) by the EZN method and one sample was positive for gram-positive bacilli by gram stain.
CONCLUSION
Small, superficial trucut biopsies may cause difficulties in determining the etiology and differential diagnosis of granulomatous mastitis. For optimal management and timing the appropriate therapy, the ideal biopsy procedure, special stains, and a multidisciplinary team consisting of the surgeon, pathologist, and radiologist are the most important issues.
Topics: Adult; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Breast; Female; Granulomatous Mastitis; Humans; Retrospective Studies
PubMed: 34558655
DOI: 10.5146/tjpath.2021.01554 -
The Indian Journal of Medical Research Dec 2018Postpartum uterine infections such as metritis, endometritis and mastitis have been considered as underlying causes for ovarian dysfunction in mammals. Almost all... (Review)
Review
Postpartum uterine infections such as metritis, endometritis and mastitis have been considered as underlying causes for ovarian dysfunction in mammals. Almost all mammals, particularly dairy animals are susceptible to postpartum uterine infections, resulting in impaired fertility and economic loss. One of the factors for low fertility in females is ovarian dysfunction, which is exhibited as impaired growth and function of ovarian follicles by the postpartum infection. Immune system of mammals provides a host defence mechanism against pathogenic microbes through the recognition of pathogen-associated molecular patterns (PAMPs) and forming inflammasomes. Like immune cells, ovarian granulosa cells also exhibit a similar pattern of cytokine gene expressions on exposure to PAMPs. Genome-wide transcriptomic approaches explored the molecular mechanisms underlying the immune function of buffalo granulosa cells during endotoxin exposure. Understanding the molecular mechanism of ovarian dysfunction due to uterine infection would be helpful to implement various strategies to handle the adverse effects of postpartum uterine disease on fertility by developing potential therapeutics. Therefore, this article focuses on key factors that are responsible for postpartum infection and particularly summarizes the molecular mechanism of infection underlying the ovarian dysfunction in dairy animals.
Topics: Animals; Cattle; Endometritis; Female; Fertility; Infections; Mastitis; Postpartum Period; Uterine Diseases; Uterus
PubMed: 30964082
DOI: 10.4103/ijmr.IJMR_961_18 -
Journal of Mammary Gland Biology and... Jun 2021An understanding of the anatomy, histology, and development of the equine mammary gland underpins study of the pathology of diseases including galactorrhoea, agalactia,... (Review)
Review
An understanding of the anatomy, histology, and development of the equine mammary gland underpins study of the pathology of diseases including galactorrhoea, agalactia, mastitis, and mammary tumour development. This review examines the prenatal development of the equine mammary gland and the striking degree to which the tissue undergoes postnatal development associated with the reproductive cycle. The gland is characterised by epithelial structures arranged in terminal duct lobular units, similar to those of the human breast, supported by distinct zones of intra- and interlobular collagenous stroma. Mastitis and mammary carcinomas are two of the most frequently described equine mammary pathologies and have an overlap in associated clinical signs. Mastitis is most frequently associated with bacterial aetiologies, particularly Streptococcus spp., and knowledge of the process of post-lactational regression can be applied to preventative husbandry strategies. Equine mammary tumours are rare and carry a poor prognosis in many cases. Recent studies have used mammosphere assays to reveal novel insights into the identification and potential behaviour of mammary stem/progenitor cell populations. These suggest that mammospheres derived from equine cells have different growth dynamics compared to those from other species. In parallel with studying the equine mammary gland in order to advance knowledge of equine mammary disease at the interface of basic and clinical science, there is a need to better understand equine lactational biology. This is driven in part by the recognition of the potential value of horse and donkey milk for human consumption, particularly donkey milk in children with 'Cow Milk Protein Allergy'.
Topics: Animals; Equidae; Female; Lactation; Mammary Glands, Animal; Mammary Neoplasms, Animal; Mastitis; Streptococcus
PubMed: 33280071
DOI: 10.1007/s10911-020-09471-2 -
Archives of Disease in Childhood Sep 2003The process of lactation and feeding, referred to by some as the final stage of labour is remarkably successful. This phase of infant care has been subjected to... (Review)
Review
The process of lactation and feeding, referred to by some as the final stage of labour is remarkably successful. This phase of infant care has been subjected to considerable evolutionary pressure since the earliest mammals, reptiles and birds diversified. It has allowed thousands of species to occupy a vast range of ecological niches. Yet a significant complication of breast feeding remains inflammation of the lactating tissue: the pathology of mastitis. Mastitis rarely develops outside lactation, although it may affect individuals at any age in relation to congenital lesions such as duct ectasia, chronic disseminated infections such as tuberculosis, or during granulomatous, autoimmune or malignant processes. The immunology and consequences of mastitis as well as its impact on vertical transmission of infection require careful examination.
Topics: Breast Feeding; Female; Humans; Infant, Newborn; Lactation; Mastitis; Milk, Human
PubMed: 12937109
DOI: 10.1136/adc.88.9.818 -
International Breastfeeding Journal Mar 2022Lactational mastitis is an extremely painful and distressing inflammation of the breast, which can seriously disrupt breastfeeding. Most of the evidence on the frequency...
BACKGROUND
Lactational mastitis is an extremely painful and distressing inflammation of the breast, which can seriously disrupt breastfeeding. Most of the evidence on the frequency of this condition and its risk factors is from high-income countries. Thus, there is a crucial need for more information on lactational mastitis and its associated factors in Sub-Saharan Africa (SSA).
METHODS
We used data from representative, community-based cross-sectional household surveys conducted in 2020 with 3,315 women from four countries (Ethiopia, Kenya, Malawi, and Tanzania) who reported ever-breastfeeding their last child born in the two years before the survey. Our measure of lactational mastitis was self-reported and defined using a combination of breast symptoms (breast redness and swelling) and flu-like symptoms (fever and chills) experienced during the breastfeeding period. We first estimated country-specific and pooled prevalence of self-reported lactational mastitis and examined mastitis-related breastfeeding discontinuation. Additionally, we examined factors associated with reporting mastitis in the pooled sample using bivariate and multivariable logistic regression accounting for clustering at the country level and post-stratification weights.
RESULTS
The prevalence of self-reported lactational mastitis ranged from 3.1% in Ethiopia to 12.0% in Kenya. Close to 17.0% of women who experienced mastitis stopped breastfeeding because of mastitis. The adjusted odds of self-reported lactational mastitis were approximately two-fold higher among women who completed at least some primary school compared to women who had no formal education. Study participants who delivered by caesarean section had 1.46 times higher odds of reporting lactational mastitis than women with a vaginal birth. Despite wide confidence intervals, our models also indicate that young women (15 - 24 years) and women who practiced prelacteal feeding had higher odds of experiencing lactational mastitis than older women (25 + years) and women who did not give prelacteal feed to their newborns.
CONCLUSIONS
The prevalence of lactational mastitis in four countries of SSA might be somewhat lower than estimates reported from other settings. Further studies should explore the risk and protective factors for lactational mastitis in SSA contexts and address its negative consequences on breastfeeding.
Topics: Adult; Africa, Southern; Breast Feeding; Cesarean Section; Cross-Sectional Studies; Female; Humans; Infant, Newborn; Mastitis; Pregnancy; Prevalence
PubMed: 35346272
DOI: 10.1186/s13006-022-00464-x