Abstract:

Objective

To explore and summarize the clinical features and treatment of periductal mastitis and granulomatous mastitis.

Methods

From May 2005 to January 2010 a total of 36 patients with periductal mastitis or granulomatous mastitis were treated in our hospital. The clinical data of the 36 patients were retrospectively analyzed.

Results

The pathological examination result showed periductal mastitis in 25 patients and granulomatous mastitis in 11. The two diseases manifested mainly as repeated abscess, breast lump and sinus or fistula cannulas. In all the 25 patients with periductal mastitis the lesions were located in 2 cm area within the areola, and 14 of them were combined with mammary papilla invagination. Four patients (16%) were treated with operation and cured, ten patients(40%) were treated with anti-nontuberculosis mycobacteria drugs plus operation and cured,six patients (24%) were treated with the drugs only and cured. The follow-up of 2-27 months demonstrated no recurrence. The rest 5 patients were still receiving antinontuberculosis mycobacteria therapy, when their conditions would permit operation would be performed. In the 11 patients with granulomatous mastitis nine had their lesions located in the 2 cm area outside the areola, without mammary papilla invagination. Seven patients received anti-nontuberculosis mycobacteria drugs therapy first till the mass became smaller about 1-2 cm in size and their disease condition was stable the masses were resected. Six of them were cured and no recurrence happened by 6-24 months of follow-up, and one patient had recurrence three months after operation, received the drug therapy again for two months,reoperated on and cured, and 12-month follow-up showed no recurrence. Tow patients had recurrence after cortical hormone treatment, were retreated with the same drugs for two weeks, then the lesions were resected, and no recurrence was found. Two patients were still having anti-nontuberculosis mycobacteria therapy and when their masses would decrease in size operation would be done. In the two groups no patients had excision of the whole breast.

Conclusions

The clinical features of periductal mastitis and granulomatous mastitis are similar. Pathological examination is the key method for diagnosis. Operation is the main treatment for the two diseases. If a patient has complex lesion, anti-nontuberculosis mycobacteria therapy is given first till the lesion becomes smaller and disease condition is stable operation is performed. In this way better result can be obtained.

Key words: periductal mastitis, granulomatous mastitis, treatment, diagnosis