Mastitis is a condition characterized by breast tissue inflammation. The inflammation causes breast discomfort, edema, heat, and redness. A fever and chills are also present in the patient. Breastfeeding women are more susceptible to developing mastitis (lactation mastitis). Mastitis, however, affects non-breastfeeding women as well as males. Mastitis arises when germs from the skin or saliva invade the breast tissue through a milk duct or a crack in the skin. Milk ducts are an integral component of the anatomy of the breast and are responsible for transporting milk to the nipples. Everyone, regardless of gender, contains milk ducts and is susceptible to mastitis.
Granulomatous mastitis, often known as GM, is an acute form of breast inflammation that most commonly affects premenopausal women. Patients often experience significant symptoms for a while, but symptoms typically subside with or without therapy, and breasts nearly return to normal. Granulomatous mastitis is distinguished by non-caseating granulomas that are frequently accompanied by the production of microabscesses and fistulas.
Chronic granulomatous mastitis is characterized by a heterogeneous inflammatory infiltrate that includes histiocyte clusters and multinucleated giant cells (granulomata).
Granulomatous Mastitis Symptoms
The primary symptoms are a palpable mass, retraction of the skin or nipple, breast discomfort, and edema. GM is mostly characterized by a painful mass. An erythema and a swelling of the affected breast are also indications of inflammation that mostly appears in up to fifty percent of individuals. Hyperemia, retraction of the areolae, fistula, and ulceration are further manifestations of this uncommon illness. The most typical clinical manifestation is a breast mass that is firm, unilateral, and identifiable on its own. This breast mass is frequently accompanied by an abscess or infection of the skin that covers it as well as fistulae. Many patients show symptoms of an abscess.
The lesion can arise in any breast quadrant but is more prevalent in the retro areolar region, from which it radiates outward. The majority of lesions appear unilaterally. Lymphadenopathy is also present in many patients. The diagnostic process is frequently misled by vague symptoms.
Granulomatous Mastitis Causes
Mastitis is mostly brought on by milk that becomes stuck in the breast. Other common causes are primarily:
- If the breast does not completely drain during feedings, one of the milk ducts becomes blocked. The obstruction causes milk to accumulate, resulting in breast infection.
- Infection of the breast also occurs when germs from the baby’s skin or mouth enter the milk ducts through a break in the nipple’s skin or a milk duct hole.
There is no clear knowledge of the underlying cause of this persistent and recurrent inflammation. This is similar to autoimmune disorders such as lupus, rheumatoid arthritis, and inflammatory thyroid disease (such as Grave’s or Hashimoto’s thyroiditis), in which the body’s inflammatory cells mistakenly react against its tissue instead of bacteria or fungi. In most cases, the condition is caused by an inflammatory disease, an infection, a chemical response connected with oral contraceptive tablets, or even lactation.
Granulomatous Mastitis Treatment
Granulomatous mastitis, often known as GM, is an extremely uncommon chronic inflammatory breast illness that possesses no clear cause. There is currently no treatment that is universally recognized as the best option for GM. The most commonly used treatments include corticosteroid therapy and/or extensive excision.
All GM treatments are symptomatic, similar to the treatment of the common cold. There is no treatment available, and surgery is rarely helpful. Avoiding cigarettes, decreasing weight, and managing diabetes all help in the management of this disease. The treatments begin with taking two to three over-the-counter ibuprofen tablets every six hours to tone down the excessive inflammation that develops within the body. If this treatment is not effective, a stronger anti-inflammatory medication, such as steroids (often administered in a course lasting 30 days, with one pill taken daily), or an injection of steroids directly into the phlegmon is often utilized.
In addition to corticosteroids and antibiotics, other treatment options for GM include drainage of abscesses, broad surgical excision, and possibly mastectomy. The use of corticosteroids and/or a radical surgical resection is described as beneficial in several studies. The best course of action for treating GM sufferers is not yet known.