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Granulomatous Mastitis Overview

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The next type of mastitis that I want to

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talk about is granulomatous mastitis,

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and this is an inflammatory breast disease

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which is thought to be associated with

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pregnancy and lactation, but it can occur

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after pregnancy and lactation have ended,

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so often occurs within five years of pregnancy.

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The cause is unknown.

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But there's formation of non-caseating

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granulomas, which are centered on the lobules,

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and there are multiple areas of peripheral

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involvement, and it can have abscesses as well.

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This is more of a chronic process, lasting

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months, presenting as a painful, palpable

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mass, maybe with an area of skin redness.

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And the patient may have systemic symptoms

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of fever and malaise, but the presentation

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is a little bit different than that acute

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lactational mastitis that we saw earlier.

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On ultrasound, we'll see hypoechoic masses

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with tubular extensions into the tissue.

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Mammography may show an

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asymmetry or an irregular mass.

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These cases are often treated with oral

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steroids, um, followed by immunosuppressant

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therapy or prolactin inhibitors.

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They may need, uh, abscess

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drainage or a surgical excision.

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

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neutrophilic granulomatous mastitis,

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which is associated with Corynebacterium infection.

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So treatment of the infection can

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help, uh, relieve the symptoms.

Report

Faculty

Lisa Ann Mullen, MD

Assistant Professor; Breast Imaging Fellowship Director

Johns Hopkins Medicine

Tags

Women's Health

Ultrasound

Non-infectious Inflammatory

Mammography

Breast

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