Topic 11

Granulomatous mastitis

Granulomatous mastitis is the breast condition most often mistaken for cancer. It is not an infection: it is a chronic inflammation the body directs at its own breast tissue.

The washbasin and height-and-weight scale in the examination room

Can it be confused with cancer

Granulomatous mastitis is not cancer. But it imitates cancer closely on examination, on ultrasound and on mammography alike. That is why patients can spend months with the wrong diagnosis.

It is usually seen in women in their thirties who have given birth and breastfed. There is redness, a firm lump, abscess formation, openings that discharge and inflammation that simply will not heal. It recurs often.

Diagnosis and treatment

The definite diagnosis is made by tru-cut biopsy alone. Treatment calls for patience. Surgery used to be recommended straight away; today we know that unnecessary, wide operations make the condition worse.

Medication

Corticosteroids and immune-modulating drugs form the basis of treatment.

Drainage if needed

Where an abscess has formed, it is drained under ultrasound guidance.

In resistant cases

In patients who do not respond, limited surgery comes onto the agenda; wide operations are avoided.

Follow-up by an experienced surgeon matters in this condition. Treatment can take between six months and a year, but it resolves completely.

Appointment

Unnecessary surgery can be avoided

In this condition wide surgery usually makes the picture worse. The right diagnosis and a patient treatment plan make recovery without an operation possible.