0:00

The next type of mastitis that I want to

0:03

talk about is granulomatous mastitis,

0:06

and this is an inflammatory breast disease

0:08

which is thought to be associated with

0:09

pregnancy and lactation, but it can occur

0:13

after pregnancy and lactation have ended,

0:16

so often occurs within five years of pregnancy.

0:19

The cause is unknown.

0:21

But there's formation of non-caseating

0:22

granulomas, which are centered on the lobules,

0:26

and there are multiple areas of peripheral

0:29

involvement, and it can have abscesses as well.

0:32

This is more of a chronic process, lasting

0:36

months, presenting as a painful, palpable

0:39

mass, maybe with an area of skin redness.

0:44

And the patient may have systemic symptoms

0:46

of fever and malaise, but the presentation

0:49

is a little bit different than that acute

0:51

lactational mastitis that we saw earlier.

0:56

On ultrasound, we'll see hypoechoic masses

0:59

with tubular extensions into the tissue.

1:01

Mammography may show an

1:03

asymmetry or an irregular mass.

1:05

These cases are often treated with oral

1:07

steroids, um, followed by immunosuppressant

1:10

therapy or prolactin inhibitors.

1:13

They may need, uh, abscess

1:15

drainage or a surgical excision.

1:17

And there's a subtype of this called, uh, cystic

1:21

neutrophilic granulomatous mastitis,

1:24

which is associated with Corynebacterium infection.

1:27

So treatment of the infection can

1:29

help, uh, relieve the symptoms.

Granulomatous Mastitis Overview

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0:00

The next type of mastitis that I want to

0:03

talk about is granulomatous mastitis,

0:06

and this is an inflammatory breast disease

0:08

which is thought to be associated with

0:09

pregnancy and lactation, but it can occur

0:13

after pregnancy and lactation have ended,

0:16

so often occurs within five years of pregnancy.

0:19

The cause is unknown.

0:21

But there's formation of non-caseating

0:22

granulomas, which are centered on the lobules,

0:26

and there are multiple areas of peripheral

0:29

involvement, and it can have abscesses as well.

0:32

This is more of a chronic process, lasting

0:36

months, presenting as a painful, palpable

0:39

mass, maybe with an area of skin redness.

0:44

And the patient may have systemic symptoms

0:46

of fever and malaise, but the presentation

0:49

is a little bit different than that acute

0:51

lactational mastitis that we saw earlier.

0:56

On ultrasound, we'll see hypoechoic masses

0:59

with tubular extensions into the tissue.

1:01

Mammography may show an

1:03

asymmetry or an irregular mass.

1:05

These cases are often treated with oral

1:07

steroids, um, followed by immunosuppressant

1:10

therapy or prolactin inhibitors.

1:13

They may need, uh, abscess

1:15

drainage or a surgical excision.

1:17

And there's a subtype of this called, uh, cystic

1:21

neutrophilic granulomatous mastitis,

1:24

which is associated with Corynebacterium infection.

1:27

So treatment of the infection can

1:29

help, uh, relieve the symptoms.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Lesson

Sample Lesson

Lesson

Palpable Lumps

Lesson

Breast Pain

Lesson

Nipple Discharge

Lesson

Skin Changes/Inflammation

Lesson

Recall from Screening

Lesson

Surveillance After Breast Cancer Treatment

Lesson

Follow Up Probably Benign Findings - BI-RADS 3

Lesson

Follow up Benign Biopsy

Lesson

Pregnant and Lactating Women

Lesson

Male Patients

Granulomatous Mastitis Overview