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Introduction: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of the breast tissue with unknown etiology. Due to the appearance of most cases of the disease in reproductive age and in women with a history of pregnancy and breastfeeding, the present study was performed with aim to investigate fertility indicators in IGM.Methods: This retrospective study was conducted in 2018-2019 on 240 women, including 80 patients with idiopathic granulomatous mastitis and 160 healthy individuals, referred to the breast clinic of Kurdistan University of Medical Sciences-Iran. Data related to the variables of age, BMI, number of pregnancies, duration of breastfeeding, age of first pregnancy, age of first menstrual period and history of taking contraceptive pills were collected by referring to patients' records in order to determine the relationship of each of these variables with the disease. Data analysis was done using SPSS software (version 25) and independent t-test and Fisher test. P0.05).Conclusion: The present study showed that patients with IGM had a higher BMI, more number of pregnancies, and a longer duration of breastfeeding compared to non-affected people; Age, age of first pregnancy, age of first menstruation, and history of OCP use had no significant relationship with IGM.

Mendrika Fifaliana Rakotoarisaona,1 Tsiory Irintsoa Razafimaharo,1 Naina Harinjara Razanakoto,1 Fandresena Arilala Sendrasoa,1 Anne Ducournau,2 Christine Devalland,3 Anne-Sophie Dupond,2 Irina Mamisoa Ranaivo,4 Lala Soavina Ramarozatovo,1 Fahafahantsoa Rapelanoro Rabenja1 1Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar; 2Department of Dermatology, Nord Franche-Comté Hospital, Trevenans, France; 3Department of Pathology, Nord Franche-Comté Hospital, Trevenans, France; 4Department of Dermatology, University Hospital Morafeno, Toamasina, MadagascarCorrespondence: Mendrika Fifaliana Rakotoarisaona, Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Rue Dr Davioud Jacques, Antananarivo, 101, Madagascar, Tel/Fax +261 34 61947 34, Email lulubslj@gmail.comIntroduction: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease. Neoplastic and infectious etiologies must be ruled out. IGM is a diagnostic challenge for countries with high tuberculosis endemicity like Madagascar since it may clinically and radiologically mimic breast tuberculosis. We report a case of IGM associated with erythema nodosum in a Malagasy.Case Report: A 29-year-old primiparous woman came to a dermatological consultation for typical erythema nodosum lesions that appeared one month after a breast swelling. She had no particular medical history. Examination revealed typical erythema nodosum lesions on the legs, voluminous tender mass in the right breast. Bacteriological samples and tuberculosis test were negative. Imaging showed mastitis on the right breast with no evidence of malignancy. Histology revealed a non-caseating granulomas on the lobule of the right breast. As part of an etiological work-up, COVID-19 serology was performed with a positive IgG antibody. The diagnosis of IGM associated with erythema nodosum was evocated. The evolution was favorable under systemic corticosteroid therapy.Discussion: The cause of this uncommon lesion remains obscure. The extramammary localizations such as erythema nodosum and arthralgia suggest an autoimmune origin. This pathogenesis is also reinforced by a good response to systemic immunosuppression. In our patient, the etiological assessment of the mastitis revealed a chronic infection with SARS-CoV-2. Histopathology is the gold standard for the IGM diagnosis which demonstrates a lobulocentric granulomas without caseous necrosis. Oral corticosteroid therapy is the initial choice of treatment.Conclusion: Now, with several cases of concomitant IGM and EN reported, dermatologists should be aware that erythema nodosum can be one of the presenting signs of IGM, since the two conditions appear to be associated. The particularity of our case lies in the incidental discovery of SARS-CoV-2 infection. Is a chronic granulomatous disease associated with SARS-CoV-2 infection, a coincidence?Keywords: corticosteroid, erythema nodosum, granulomatous mastitis, Madagascar

Idiopathic granulomatous mastitis is a rare breast condition of unclear etiology. Its course is often rapidly progressive, slow to resolve, and can have a high rate of recurrence. Clinical presentation can mimic breast abscess, infectious mastitis, and carcinoma of the breast, generating a diagnostic challenge. Histopathological analysis is required to make the diagnosis after common conditions are excluded. There is no standard treatment, however surgical excision, steroid treatment, and observation are commonly reported approaches. Here, we describe a complex case of a multiparous patient presenting with idiopathic granulomatous mastitis at 32 weeks gestation. In this review, we highlight the importance of collaboration amongst a multidisciplinary team for effective diagnosis and treatment. We discuss the use of oral corticosteroids in the antenatal period and illustrate the patient support required to both facilitate successful breastfeeding in the postpartum period and promote recovery.

Granulomatous mastitis (GM) is a refractory chronic mastitis, which belongs to the category of “acne mammary abscess” and “ulcer” in Traditional Chinese External Medicine. According to yin-yang syndrome differentiation, the disease can be divided into yin syndrome, yang syndrome, and half-yin and half-yang syndrome. Among them, the theories and treatment of yin syndrome and yang syndrome are relatively comprehensive in Traditional Chinese External Medicine. However, the half-yin and half-yang syndrome lacks a specific theoretical elaboration and treatment system, which is a special and complex syndrome of the disease, limiting the improvement of the clinical efficacy of the disease. The core pathogenesis of GM with half-yin and half-yang syndrome is “obstruction of nutritive and defensive phases, and yin-yang obstruction.” The clinical features are local yin syndrome complicated with yang syndrome, and the disease is lingering and difficult to cure. For syndrome differentiation, it is advisable to “attach more importance to the local while less importance to the whole body.” The treatment should be based on the general principle of “eliminating yin and transforming yang.” For the use of herbs, it is recommended to adopt the methods of “the combination of the herbs in cold and warm nature, mainly with herbs in warm nature, attaching more importance to use the herbs with the function of ascending and less to descending.” Finally, restore the normal circulation of qi and blood as well as the balance of yin and yang to achieve the purpose of treatment.

Granulomatous mastitis (GM) is a rare benign mastitis disease in clinical practice. In recent years, the incidence has been increasing year by year, but so far, its etiology and pathogenesis are still unclear. This disease mainly occurs in women of childbearing age who have a history of breastfeeding, with prevalence old is 30-42 years. The main clinical manifestations are often affected breast redness, swelling, and pain, with local palpable masses and a longer course of disease. Using histopathological diagnosis as the “gold standard”, the biopsy results showed granuloma formation accompanied by multinucleated giant cells, epithelioid tissue cells, and plasma cell infiltration. At present, the treatment plans for GM include drug therapy (antibiotics, steroids, immunosuppressants), surgical treatment, traditional Chinese medicine treatment, and the combination of multiple treatment methods, but a unified diagnosis and treatment standard has not yet been formed. This article mainly provides a brief review of the common causes and pathogenesis of GM, as well as the latest progress in clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background and Objectives: Granulomatous mastitis is a benign disease with a clinical presentation similar to that of breast cancer, and is most commonly observed in women of childbearing age. Although it has been suggested that autoimmune diseases are involved in its pathogenesis, no specific treatments have been established. The occurrence of this disease during pregnancy has rarely been reported. We presented the case of a 37-year-old woman who complained of left breast induration at 24 weeks' gestation. Materials and Methods: She was pregnant and manifested a dichorionic, diamniotic placenta. At 24 weeks of gestation, the patient experienced a sensation of hardness in her left breast. Mastitis was suspected, and she was treated with cephem antibiotics. Simultaneously, she was diagnosed with erythema nodosum in the extremities. As her symptoms did not improve, an incisional drainage was performed. Bacterial cultures were obtained at 31 weeks of gestation, and Corynebacterium kroppenstedtii was detected. Results: An elective cesarean section was performed at 37 weeks of gestation, and the baby was delivered safely. After delivery, a needle biopsy was performed, and the patient was diagnosed with granulomatous mastitis. She was completely cured with prednisolone after weaning. In this case, the patient's condition was maintained through incision and drainage, as well as antibiotic, anti-inflammatory, and analgesic drugs during pregnancy. This approach was chosen, taking into consideration the potential side effects of steroids. Conclusions: This case suggests that incisional drainage and antibiotic therapy, as well as steroids and surgery, may be considered in the treatment of granulomatous mastitis occurring during pregnancy. This may also be true for management during delivery. After delivery, breastfeeding and steroidal therapy proved to be effective in treating the condition. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence has suggested that Corynebacterium kroppenstedtii is associated with some cases of granulomatous mastitis, mostly based on pathology or microbiology. We aimed to identify the clinical characteristics and treatment regimens for granulomatous mastitis with Corynebacterium kroppenstedtii infection. Understanding these clinical features is essential for patient care. Methods: We retrospectively collected data on 201 patients who were pathologically diagnosed with granulomatous mastitis and had microbiological results of either Corynebacterium kroppenstedtii or no bacterial growth and recorded and analysed their demographics, clinical characteristics, and clinical outcomes. Results: There were 107 patients in the CK group and 94 patients in the negative group. Sinus formation (x2 = 13.028, p = 0.000), time to complete remission at the first treatment period (Z = -3.027, p = 0.002), diameter of breast mass at first-time medical consultancy (Z = -2.539, p = 0.011) and recurrence (x2 = 4.953, p = 0.026) were statistically significant. Age (Z = -1.046, p = 0.295), laterality (x2 = 4.217, p = 0.121), time to presentation since the last delivery (x2 = 0.028, p = 0.868), BMI (Z = -0.947, p = 0.344), lactation time (Z = -1.378, p = 0.168), parity (x2 = 1.799, p = 0.180), gravida (Z = -0.144, p = 0.885), history of lactational mastitis or abscess (x2 = 0.115, p = 0.734), local trauma (x2 = 0.982, p = 0.322), hyperprolactinemia (x2 = 0.706, p = 0.401), erythema nodosum (x2 = 0.292, p = 0.589), and nipple discharge (x2 = 0.281, p = 0.596) did not demonstrate statistical significance. Regarding recurrence related to therapeutic strategy, except for surgery combined with immunosuppressants (x2 = 9.110, p = 0.003), which was statistically significant, none of the other treatment regimens reached statistical significance. The recurrence rate of patients in the CK group using rifampicin in their treatment course was 22.0% (x2 = 4.892, p = 0.027). Conclusions: Granulomatous mastitis accompanied by Corynebacterium kroppenstedtii more easily forms sinuses and has a higher recurrence rate. Both of the clinical characteristics may indicate that Corynebacterium kroppenstedtii plays an important role in the development and progression of granulomatous mastitis. Lipophilic antibiotics may be essential for granulomatous mastitis with Corynebacterium kroppenstedtii infection. [ABSTRACT FROM AUTHOR]

Introduction: There are multiple management modalities for idiopathic granulomatous mastitis, but the treatment of choice is still under debate. This study aims to evaluate the diagnosis and outcomes of different management modalities in patients with idiopathic granulomatous mastitis and to identify the risk factors associated with recurrence. Method: This is a single-group cohort study that included those patients who had idiopathic granulomatous mastitis. Ultrasonography was conducted for all of the cases using LOGIQ E9 with an ML6-15 transducer (5–15 MHz). A core needle biopsy was conducted to take samples from the cases for histopathological examination. The patients were put on steroid therapy. Whenever the cases did not respond to the steroid therapy, treatment with a combination of low-dose steroids and methotrexate was started. In the lack of response to conservative treatments, surgical interventions were started. Results: Sixty-three cases with a confirmed histopathological diagnosis of granulomatous mastitis were included. The mean age of patients was 35.7 years. The history of more than one childbirth was positive in a large portion of the cases (82.5%). The lesion side was unilateral in 58.7% of the cases. A large proportion of the lesions were classified as BIRADS category 2. The best treatment outcome was yielded by a combination of low-dose steroids and incision and drainage. The factors of age, lesion area (cm2), skin thickening, and white blood cell count enhanced the chance of recurrence. Conclusion: Incision and drainage in combination with a low dose of steroids can give an acceptable outcome with a low rate of recurrence. [ABSTRACT FROM AUTHOR]

Introduction: There has been a growing increase in the incidence of breast cancer, which is still the most significant cancer-related cause of female mortality. All breast lesions are not malignant, and all the benign lesions do not progress to cancer; however, the accuracy of diagnosis can be increased by a combination of preoperative tests (like physical examination, mammography, fine-needle aspiration cytology, and core-needle biopsy [CNB]). Aim: To study the breast mass which mimicks malignant lesion clinically and their further evaluation with the help of core needle biopsy and fine needle aspiration cytology. Materials and Methods: Prospective evaluation of the breast masses which mimicks malingnant lesion clinically at IPGME &R and SSKM Hospital kolkata from January 2019 to June 2020 at department of pathology. We studied the cases of breast masses. This comprised patient age and sex, the clinical characteristics and location of the mass, the duration of the lesion, its size, the treatment provided, and the histopathological findings obtained from fine-needle aspiration cytology (FNAC) and CNB. Results: We present six clinical cases in which a diagnosis dilemma existed, in terms of ultrasound findings that were not clear and suspicious. The results of FNAC and CNB are used to distinguish between benign breast lesions mimicking carcinoma of breast. Our findings are compared with previously published cases. Furthermore, literature review regarding the case presentation and diagnosis has been discussed, as well as treatment options. Conclusion: Accurate preoperative diagnosis of carcinoma is necessary in screen-detected lesions so that patients may be counseled appropriately and a majority could have a single therapeutic operation. Benign breast lesion mimicking breast carcinoma should be differentiated. Combining FNAC and CNB for screening-detected breast cancers, the complete sensitivity increases from 93% for CNB only to 98% when both tests are combined.

Background/aim: Granulomatous mastitis (GM) is a rare inflammatory disease of the breast. Tuberculosis mastitis (TM), one of the causes of GM, is a rare form of extrapulmonary tuberculosis. The clinical, radiological, and histopathological findings of TM and GM are similar, and sometimes it is difficult to make a distinction between these disease states. In this study, we aimed to evaluate the clinical and radiological features, diagnostic techniques, treatment modalities and treatment outcomes of the patients with GM and TM. Materials and methods: The data of the patients with confirmed GM by histopathologic examination of biopsy specimens between 2007 and 2020 were retrospectively analyzed. Demographic features, main complaints, physical findings, radiological and laboratory data, treatment modalities, and treatment outcomes were recorded. Results: Sixty-eight GM patients with a mean age of 35.8 (18-63) years were evaluated. The patients had a mass lesion, pain, ulceration, and abscess in their breasts. All of the cases were female. Ultrasonographic examinations were performed on 62 cases. Abscess and/or sinus tract formation was detected in 34, heterogeneous hypoechoic mass in 15, heterogeneous parenchyma or parenchymal edema in 15, axillary lymphadenopathy in 18 and cysts in 13 patients. A total of 10 patients were lost to follow-up. Twenty-six patients underwent surgery for their breast lesions or had antibiotherapy (n = 13) or corticosteroid therapy (n = 7). Eleven (16.1%) patients were diagnosed with TM. These patients were evaluated by clinical examination, chest radiography, and tuberculin skin test. Acid-fast bacilli (AFB) staining and culture were negative in all cases. The diagnosis of TM was based on histopathological evaluation results. Eight of the 11 patients achieved complete remission with antituberculosis treatment. Conclusion: The etiological diagnosis of GM must be based on a multidisciplinary approach. Tuberculosis mastitis should become a part of differential diagnosis of breast diseases in populations with high incidence of tuberculosis. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the value of pre-treatment dynamic contrast-enhanced MRI (DCE-MRI) findings in predicting clinical and radiological response to treatment in patients with idiopathic granulomatous mastitis (IGM) receiving steroid therapy and to compare clinical and DCE-MRI results after treatment. Methods: Pre- and post-treatment MRI examinations of 86 patients (with a mean age of 33.8 years; range, 20-57 years) diagnosed with IGM between January 2014 and September 2022 were retrospectively evaluated. Lesion characteristics and longest diameter, number of involved quadrants, retroareolar involvement, and presence of fistula or lymphadenopathy were noted. Patients were categorized into clinical complete response (CCR), clinical non-response (CNR) groups based on clinical response and into radiological complete response (RCR) and radiological non-response (RNR) groups based on radiological response. Results: The analyses revealed no relationship between the lesion type (abscess, NME, abscess, and NME), presence of lymphadenopathy or fistula, number of involved quadrants, retroareolar involvement, and treatment response on pretreatment MRI (P>0.05). The longest lesion diameter was smaller in the CCR group than in the CNR group (P = 0.02). After treatment, 40.7% (35/86) of the patients achieved RCR + CCR, while 16.3% (14/86) achieved RNR + CNR. On the other hand, 43% (37/86) of the patients achieved CCR + RNR. Conclusion: CCR is more common in patients with smaller lesions. Other pretreatment MRI findings were not correlated with radiological or clinical response. A significant proportion of patients with CCR had residual lesions radiologically. [ABSTRACT FROM AUTHOR]

Introduction: Granulomatous mastitis (GM) is a chronic inflammatory breast disease. In recent years, the role of Corynebacterium in GM onset has received more andmore attention. This study aims to detect the dominant bacteriumin GM patients and analyze the association between clinical characteristics and infectious factors. Methods: In this study, 88 samples from 44 GM patients, six acute lactation mastitis (ALM) patients, and 25 non-inflammatory breast disease (NIB) patients were divided into a GM pus group, a GM tissue group, an ALM pus group, and a NIB tissue group; then, 16S ribosomal DNA sequencing was used to explore their microbiota. The clinical data of all 44 GM patients were also retrospectively collected and analyzed to determine their relationship with infection. Results: Themedian age of the 44 GMpatients was 33 years, and 88.6% of patients had primary-onset cases, while 11.4% were recurrences; additionally, 89.5% of patients were postpartum and 10.5% were nulliparous. The serum prolactin level was abnormal in nine patients (24.3%). Samples from 15 GM patients (34.1%) had a Corynebacterium abundance of >1% (1.08-80.08%), with eight (53.3%) displaying an abundance of >10%. Corynebacterium was the only genus with significant differences between the GM pus group and the other three groups (p < 0.05). Corynebacterium kroppenstedtii was the predominant Corynebacterium species. Among clinical characteristics, a statistical di_erence in breast abscess formation was observed according to Corynebacterium abundance in Corynebacterium-positive and- negative patients (p < 0.05). Discussion: This study explored the relationship between Corynebacterium infection and GM, compared the clinical characteristics between Corynebacterium-positive and- negative patients, and provided support for the role of Corynebacterium species-in particular, C. kroppenstedtii-in the pathogenesis of GM. The detection of Corynebacterium can predict GM onset, especially in patients with high prolactin levels or a history of recent lactation. [ABSTRACT FROM AUTHOR]

Objective: To compare and determine discriminative magnetic resonance imaging (MRI) findings of idiopathic granulomatous mastitis (IGM) and breast cancer (BC) that present as non-mass enhancement. Materials and Methods: This retrospective study includes 68 IGM and 75 BC cases that presented with non-mass enhancement on breast MRI. All patients with a previous history of breast surgery, radiotherapy, or chemotherapy due to BC or a previous history of mastitis were excluded. On MRI images, presence of architectural distortion skin thickening, edema, hyperintense ducts containing protein, dilated fat-containing ducts and axillary adenopathies were noted. Cysts with enhancing walls, lesion size, lesion location, fistulas, distribution, internal enhancement pattern and kinetic features of non-mass enhancement were recorded. Apparent diffusion coefficient (ADC) values were calculated. Pearson chi-square test, Fisher's exact test, independent t test and Mann–Whitney U test were used as needed for statistical analysis and comparison. Multivariate logistic regression model was used to determine the independent predictors. Results: IGM patients were significantly younger than BC patients (p < 0.001). Cysts with thin (p < 0.05) or thick walls (p = 0.001), multiple cystic lesions, (p < 0.001), cystic lesions draining to the skin (p < 0.001), and skin fistulas (p < 0.05) were detected more often in IGM. Central (p < 0.05) and periareolar (p < 0.001) location and focal skin thickening (p < 0.05) were significantly more common in IGM. Architectural distortion (p = 0.001) and diffuse skin thickening (p < 0.05) were associated with BC. Multiple regional distribution was more common in IGM, whereas diffuse distribution and clumped enhancement were more common in BC (p < 0.05). In kinetic analysis, persistent enhancement was more common in IGM, whereas plateau and wash-out types were more common in BC (p < 0.001). Independent predictors for BC were age, diffuse skin thickening and kinetic curve types. There was no significant difference in the diffusion characteristics. Based on these findings, MRI had a sensitivity, specificity and accuracy of 88%, 67.65%, and 78.32%, respectively, in differentiating IGM from BC. Conclusions: In conclusion, for non-mass enhancement, MRI can rule out malignancy with a considerably high sensitivity; however, specificity is still low, as many IGM patients have overlapping findings. Final diagnosis should be complemented with histopathology whenever necessary. [ABSTRACT FROM AUTHOR]

Objective: Idiopathic granulomatous mastitis (IGM) is an inflammatory breast disease that is often challenging to differentiate from malignancy. This study investigated the role of diffusion-weighted (DW) magnetic resonance imaging in differentiating IGM from malignant breast lesions. Methods: This retrospective study included 82 female patients with IGM [with a mean age of 33.48 years, minimum (min): 22 - maximum (max): 58 years] and 85 female patients with breast cancer (with a mean age of 48.14 years, min: 31 - max: 79 years). The diagnoses of all patients were confirmed by biopsy, including 114 IGM lesions and 115 malignant lesions in the analysis. DW sequences were acquired with b-values of 0 and 1000 mm²/sec on a 1.5 T device. The apparent diffusion coefficient (ADC) values of the lesions were measured manually by placing multiple regions of interest of 50-100 mm² in the target lesions and contralateral normal parenchyma. Results: The ADC values of both IGM (1.119±0.454x10-3 mm²/s) and malignant lesions (1066±0.610x10-3 mm²/s) were lower than those of normal parenchyma. The ADC values of the mastitis group were significantly higher than the ADC values of the carcinoma group (p=0.00). The inter-observer (r=0.627) and intra-observer (r=0.775) agreement of ADC measurements were strong. Conclusion: DW imaging is a useful noninvasive technique to differentiate between IGM and breast carcinoma. [ABSTRACT FROM AUTHOR]

Granulomatous mastitis (GM) is a rare disease, particularly among men. Herein, we present a case of GM diagnosed in a 63‐year‐old male patient who showed reduction in the tumor size during 3 months of observation. [ABSTRACT FROM AUTHOR]

Granulomatous mastitis (GM) is a benign, inflammatory condition of the breast that mainly affects women of reproductive age. Although its pathogenesis remains unknown, previous studies revealed an association between autoimmune rheumatic diseases (ARDs) and GM in a subset of patients implicating immune-mediated mechanisms. The aim of this narrative review was to identify and describe the ARDs associated with GM to shed further light on disease pathogenesis. We conducted a comprehensive literature search of patients presenting with GM and coexisting ARDs using electronic databases. An association between GM and various ARDs has been reported, including sarcoidosis, systematic lupus erythematosus, granulomatosis with polyangiitis, psoriasis/psoriatic arthritis, familial Mediterranean fever, ankylosing spondylitis, Sjogren's syndrome, rheumatoid arthritis, and erythema nodosum, with the most common being granulomatous mastitis—erythema nodosum–arthritis syndrome (GMENA), granulomatosis with polyangiitis (Wegener's) and sarcoidosis. In addition, clinical characteristics, diagnostic and therapeutic approaches were recorded. Further research is warranted to better understand the association between GM and ARDs and raise awareness amongst rheumatologists. [ABSTRACT FROM AUTHOR]

Objective: Granulomatous mastitis (GM) is a benign breast disease that can have an extended clinical course impacting quality of life and causing breast disfigurement. Granulomatous mastitis has been studied throughout the world; however, less is known about GM patients in the United States. We aim to identify demographic and socioeconomic factors associated with GM in the United States. Methods: An IRB-approved retrospective case-control study was performed of 92 patients with biopsy-proven GM at two institutions in Los Angeles, California: a safety-net hospital and an academic institution. Age-matched controls were selected from patients presenting for diagnostic breast imaging. Demographic and socioeconomic characteristics were collected. Data were analyzed using univariable test for odds ratios (ORs) with 95% confidence intervals (CIs) and multivariable conditional logistic regression. Results: Patients with GM were more likely to prefer Spanish language (OR 6.20, 95% CI: 2.71%-14.18%), identify as Hispanic/Latina (OR 5.18, 95% CI: 2.38%-11.30%), and be born in Mexico (OR 3.85, 95% CI: 1.23%-12.02%). Cases were more likely to have no primary care provider (OR 3.76, 95% CI: 1.97%-7.14%) and use California Medicaid for undocumented adults (OR 3.65, 95% CI: 1.89%-7.08%). In the multivariable analysis, participants who preferred Spanish language had four times higher odds of GM versus those who preferred English language (OR 4.32, 95% CI: 1.38%-13.54%). Conclusion: Patients with GM may have barriers to health care access, such as preferring Spanish language, being an undocumented immigrant, and not having a primary care provider. Given these health care disparities, further research is needed to identify risk factors, etiologies, and treatments for this subset of GM patients. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The objective of this study was to evaluate the volume changes and the findings of deformation in the breasts with granulomatous mastitis and to compare the findings with the contralateral normal breasts. METHODS: This retrospective study included histopathologically proven 15 granülomatous mastitis (GM) patients. Breast diameters in three planes and the volume were measured on Magnetic resonance imaging (MRI). Parenchymal edema, nipple retraction, and deformation of the breast were noted. RESULTS: The measurements were only showed significant increase in sagittal diameter (124.4+-26 mm and 116+-22.9 mm, for diseased and normal breasts, respectively) and volume (329.3 cc [IQR: 245–572 and 281.6 cc [IQR: 217.3–310.3] for diseased and normal sides, respectively) in the breasts with GM when compared with normal side (p

Abstract Granulomatous mastitis (GM) is a rare disease, particularly among men. Herein, we present a case of GM diagnosed in a 63‐year‐old male patient who showed reduction in the tumor size during 3 months of observation.

Objectives: This study aimed to retrospectively describe the clinicopathological pattern and management experience of idiopathic granulomatous mastitis in women receiving care at the Royal Hospital, a tertiary care centre in Oman. The study then compared the researchers' experience with the current literature trends. Methods: The data of patients from January 2012 to December 2017 were reviewed retrospectively, after receiving ethical approval from the Centre of Studies and Research. Results: This retrospective study included 64 patients were confirmed to have idiopathic granulomatous mastitis. All patients were in the premenopausal phase, with only one being nulliparous. Mastitis was the most common clinical diagnosis; furthermore, half of the patients had a palpable mass. Most patients had received antibiotics during the span of their treatment. Drainage procedure was done in 73% of the patients, whereas excisional procedure was done for 38.7%. Only 52.4% of patients were able to achieve complete clinical resolution within six months of follow-up. Conclusion: There is no standardised management algorithm due to the paucity of high-level evidence comparing different modalities. However, steroids, methotrexate and surgery are all considered to be effective and acceptable treatments. Moreover, current literature tends towards multimodality treatments planned tailored case-to-case based on the clinical context and patients' preference. [ABSTRACT FROM AUTHOR]

Digital Mammography (DM) is extensively used for breast imaging however, lesion visibility is often limited by overlapping tissues, which affects lesion characterization. Digital breast tomosynthesis (DBT) reduces the effect of overlapping tissues and helps in revealing obscured findings. We aimed to describe the mammographic findings in granulomatous and non-granulomatous mastitis and assess the utility of adjunctive DBT in lesion characterization. DM and DBT images of histo-pathologically diagnosed cases of granulomatous (GM) and non-granulomatous mastitis (NGM) were reviewed according to the BI-RADS lexicon. Presence of contiguous/ interconnected lesions, tubular densities, interspersed hypodensities/fat densities within the involved areas were also assessed. The perceived utility of adjunct DBT was scored from 0-2. Of 33 reviewed patients (24 GM, 9 NGM; median age 39 years, range 24-78); 13/33 (39.4%) were under 35 years of age. DBT detected masses in 24/33 (72.7%), whereas only 15/33 (45.4%) were visible on DM alone. Contiguous or inter-connected lesions were found in 10/33 (30.3%) cases. Tubular extensions were seen in 14 cases and interspersed hypodensities in 15. None of the enlarged lymph nodes had irregular shape or indistinct margins or loss of fatty hilum. DBT was able to categorize more lesions as BIRADS 4a or below, as compared to DM alone. Mammographic presence of multiple contiguous iso-dense masses, reniform contour of axillary lymph nodes with preserved fatty hilum despite a large area of breast involvement favour a benign etiology; especially if DBT reveals tubular extensions or lesions with inhomogenous low density areas within. [ABSTRACT FROM AUTHOR]

Inflammatory granulomatous mastitis is a benign inflammatory disease of the breast mostly presenting in puerperal women. The disease is characterized by recurrent bouts of mastitis with clinical picture of hyperemia, breast mass, and swelling of the breast with or without purulent discharge depending on the severity of the underlying inflammatory process. Although no true prevalence and incidence have been reported in the literature, there are several reported studies setting forth a predilection in specific ethnic groups and/ or geographical areas. Due to the intricate nature of the disease, quite often inflammatory granulomatous mastitis may be mistaken for malignant processes of the breast and even so, there are no pathognomonic imaging appearances to differentiate one from another. The histopathological analysis is a definite way of diagnosis. In this article, we review the imaging manifestations and clinical and histopathological findings along with current trends of available treatment options in the literature and briefly discussed our institutional perspective regarding grading of inflammatory granulomatous mastitis based on ultrasonographic appearances. [ABSTRACT FROM AUTHOR]

Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease of the breast with an unknown etiology, characterized by the presence of sterile non-caseous granulomas and the formation of microabscesses in the lobules of the breast. The exact prevalence of this disease is still unknown. This is mainly due to the relatively small number of the reported cases, as well as the diagnostic difficulties. The aim of the study: to highlight the clinical experience of managing a patient with IGM, to explain the role of pathomorphological examination in diagnostic search, to discuss differential diagnosis and treatment modalities according to the review of English-language literature sources. When the patient visited the clinic, the chief complaint was pain in the right breast. On examination, a painless mass with indistinct border and stone-like density up to 2.5 cm was revealed at the union of the inner quadrants of the right breast. The patient underwent a number of tests: ultrasound, MSCT, mammography, MRI, which were indicative of breast cancer. The final diagnosis was made after the double histopathologically verified examination with differential diagnosis. Considering the young age of the patient, the successful experience of conservative management of patients covered in the world literature, the possible cosmetic effects after surgery, it was decided to treat with cytostatics and glucocorticoids. A 3.5- and 7.0-month follow-up of treatment results by a mammologist showed neither visible pathological changes in the breasts nor palpatory nodular or tumor mass. The state after idiopathic granulomatous mastitis was reconvalescence. The paper also discusses other methods of treatment: surgery, drug therapy such as corticosteroids (topical, oral), immunosuppressants (methotrexate, azathioprine) or a conventional follow-up of patients with mild symptoms. However, considering severe pain and significant aesthetic defects as a result of inadequate therapy, the follow-up is not dominant in the patient management. A delay in the diagnosis can lead to treatment errors, causing chronic changes and increasing the inflammatory size in the breast, influence the severity of the disease and subsequent therapy. Conclusions. The clinical case of the patient with IGM, diagnostic search and effective conservative treatment tactics have been described. The significance and indispensability of pathohistological examination in the diagnostic search have been explained. The most effective treatment regimens for IGM patients have been discussed.

Abstract Background Granulomatous mastitis (GM) is a chronic inflammatory mastitis disease that requires long-term treatment and has a high recurrence rate. Case management has been proven to be an effective mechanism in assisting patients with chronic illness to receive regular and targeted disease monitoring and health care service. The aim of this study was to investigate the application of a hospital-to-community model of case management for granulomatous mastitis and explore the related factors associated with its recurrence. Methods This was a prospective study on patients with granulomatous mastitis based on a case management model. Data on demographic, clinical and laboratory information, treatment methods, follow-up time, and recurrence were collected and analyzed. The eight-item Morisky Medication Adherence Scale (MMAS-8) was used to investigate patients' adherence to medications. Logistic regression models were built for analysis of risk factors for the recurrence of granulomatous mastitis. Results By October 2021, a total of 152 female patients with a mean age of 32 years had undergone the entire case management process. The mean total course of case management was 24.54 (range 15–45) months. Almost all the patients received medication treatment, except for one pregnant patient who received observation therapy, and approximately 53.9% of the patients received medication and surgery. The overall recurrence rate was 11.2%, and “high” medication adherence (RR = 0.428, 95% CI 0.224–0.867, P = 0.015) was significantly associated with a lower rate of recurrence, while the rate of recurrence with a surgical procedure + medication was higher than that with medication alone (RR = 4.128, 95% CI 1.026–16.610, P = 0.046). Conclusion A case management model for patients with granulomatous mastitis was applied to effectively monitor changes in the disease and to identify factors associated with disease recurrence. “Low” medication adherence was a significant risk factor for the recurrence of granulomatous mastitis. Patients treated with medication and surgery were more likely to experience recurrence than those treated with medication alone. The optimal treatment approach should be planned for granulomatous mastitis patients, and patient medication adherence should be of concern to medical staff.

Sarcoidosis is a systemic inflammatory disease of unknown aetiology. Given its complex clinical presentation, the disorder frequently causes diagnostic challenges. In most cases, the primary manifestation is in the lungs and mediastinum. Breast involvement as the primary manifestation of sarcoidosis is rare, accounting for less than 1% of cases. The authors present the case of a 44-year-old woman whose disease first manifested as multiple non-specific BIRADS 4 lesions in both breasts, accompanied by axillary lymphadenopathy, detected by ultrasound examination. The lesions were not visible on mammography. The course of the disease was clinically silent, with intermittent remissions, until the complete resolution of focal breast lesions on ultrasound after two years of follow-up. The paper presents an algorithm for the management of multifocal breast pathology with associated lymphadenopathy, which led to the prompt verification of sarcoidosis.

Granulomatous mastitis (GM) is a chronic inflammatory disease of the breast that usually occurs in women of reproductive age. However, GM during pregnancy is unusual and only one case of GM in the accessory breast has been reported so far. Here, we report an extremely rare case of GM in the accessory axillary breast of a pregnant woman. A 24-year-old pregnant woman had persistent pain and swelling in the right axilla that did not improve with antibiotic administration. Despite incision and drainage for subcutaneous abscess, the incised skin gradually became ulcerated, exposing the subcutaneous granulomatous tissue. Corynebacterium species were isolated in the bacterial culture of drained pus. Lower back pain, pain in several joints, and erythema nodosum on the lower legs appeared later. Based on the result of bacterial culture and the above disease course, the patient was clinically suspected of having GM. The axillary mass was surgically removed after childbirth, and the excised mass was histopathologically confirmed as GM. Treatment for GM should be considered individually and carefully in accordance with the patients’ condition. Unnecessary surgery should be avoided. However, early addition of surgical interventions may yield good outcomes, especially for pregnant women because of limited treatment options.

Abstract Granulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.

Abstract Background Granulomatous mastitis is a rare inflammatory disease of the breast, typically seen in woman of child-bearing age. No definitive etiology has been described. In rare instances, this condition has been reported to be associated with extramammary manifestations such as erythema nodosum and arthritis. We describe this rare condition in an adolescent female. Case presentation A 16-year-old, Hispanic female presented with right-sided painful breast swelling, polyarthritis, and erythema nodosum on bilateral shins and lower thighs. Physical examination was negative for lymphadenopathy and pulmonary, gastrointestinal, and cardiovascular findings. Ophthalmologic examination for uveitis and serologic tests for autoimmune diseases were negative. Diagnosis of idiopathic granulomatous mastitis was made by exclusion of other etiologies and conditions. Confirmation was made by histopathologic examination demonstrating noncaseating granuloma within breast lobules with neutrophils and microabscess formation. After wide local excision and a short course of trimethoprim–sulfamethoxazole, our patient was placed on naproxen and prednisone, the latter being tapered off over 3 months, with steady and complete resolution of all symptoms. Conclusion This is the first reported case of idiopathic granulomatous mastitis in a pediatric patient who also had extramammary manifestations, including erythema nodosum and polyarthritis. In this case-based review, we summarize the phenotype, risk factors, prognosis, and treatment options of this rare condition, chiefly to make the readers cognizant of such a diagnostic possibility in similar clinical presentation in the future.

Objective: Granulomatous mastitis (GM) is a challenging inflammatory disorder of the breast. In this study we aimed to present the detailed clinical and morphological features of GM cases, diagnostic clues for specific and idiopathic etiologies, the difficulties in evaluating trucut biopsies, and the results of different therapeutic approaches. Material and Method: We retrospectively analysed the clinical, radiological and morphological features of 114 GM cases diagnosed with fine needle aspiration, and trucut, incisional, and excisional biopsy. Results: The mean age was 35.8. Only eight cases were older than 45 years. Bilateral involvement was observed in 4 (3.5%) cases. The most common clinical symptoms were breast mass/abscesses, tenderness, and skin changes. Microbiological culture was positive in 4 cases for gram-positive bacteria. Only 3 cases showed a positive tuberculin/PCR test for tuberculosis. The major USG finding was a hypoechoic well-defined or ill-defined mass/abscess; MRI finding was heterogeneous non-mass contrast enhancement. Cases diagnosed with cytology (35 cases) did not have breast malignancy either in their history or clinical follow up period. Fine needle aspiration cytology materials revealed epitheloid granulomas mixed with neutrophils, lymphocytes accompanied by giant cells, and suppurative necrosis. Histopathological reevaluation of 65 trucut/incisional/ excisional biopsies revealed granuloma formation in 65 (100%), Langhans type giant cells in 59 (90.7%), microabscess formation in 41 (63%), caseous necrosis in 1 (1.5%), neutrophilic cysts in 30 (46.1%), eosinophilic infiltration in 48 (73.8%), interlobular inflammation in 14 (21.5%), fat necrosis in 5 (7.6%), ductal ectasia in 6 (9.2%), and lactational changes in 4 (6.1%) cases. Granulomas were lobulocentric in 58 cases, foreign body type/fat necrosis-related in 6 case, and periductular in 1 case. Cystic neutrophilic granulomatous mastitis was observed in one case. We also evaluated the histochemical stains of these 65 biopsies. Only one sample was positive for acido-resistant bacilli (ARB) by the EZN method and one sample was positive for gram-positive bacilli by gram stain. Conclusion: Small, superficial trucut biopsies may cause difficulties in determining the etiology and differential diagnosis of granulomatous mastitis. For optimal management and timing the appropriate therapy, the ideal biopsy procedure, special stains, and a multidisciplinary team consisting of the surgeon, pathologist, and radiologist are the most important issues.

Granulomatous mastitis (GM) is an underdiagnosed and understudied benign inflammatory disease of the breast whose accurate diagnosis is confounded by mimicry of other breast pathologies (infectious mastitis and abscess, malignancy) and limited clinician knowledge of the disease. GM disproportionately affects minority women, furthering health disparities for a demographic already disadvantaged in the care of breast diseases. The first step in diagnosis is ultrasound followed by core needle biopsy yielding granulomatous inflammation. To far lesser degree, mammography, and MRI may play a role in narrowing the differential. A high index of clinical suspicion and multidisciplinary approach is required. The presence of Corynebacterium kroppensteddti may indicate one subtype of granulomatous mastitis called cystic neutrophilic granulomatous mastitis; disease stratification, and individualized therapy are on the horizon.

This paper summarized the effect observation and nursing measures for a patient with patient with postoperative pain after granulomatous mastitis surgery under local anesthesia. On the basis of improving the routine postoperative nursing, auricular acupoint sticking and pressing therapy was carried out to relieve the postoperative pain of the patients. It has the advantages of low adverse reactions, high safety and easy acceptance by patients. (本文总结1例乳腺炎局部麻醉术后疼痛患者给予耳穴贴压治疗的效果及护理措施。在完善术后常规护理的基础上, 耳穴贴压治疗能够有效缓解患者术后疼痛, 且该方法具有不良反应小、安全性高等优势, 患者易于接受。)

Objective: The aim of this study was to investigate the role of diffusion-weighted magnetic resonance imaging (DW MRI) with an apparent diffusion coefficient (ADC) map in evaluating the response to treatment of steroid-treated idiopathic granulomatous mastitis (IGM) lesions. Materials and Methods: This retrospective study included 99 lesions of 58 female patients (average age: 32.91 years; range: 22–55 years) with biopsy-proven IGM. Patients were treated with oral and topical steroids. All pre-treatment and post-treatment MR examinations were evaluated. The maximal size of the masses and nonmass enhancement (NME) lesions were measured. Patients were classified as complete response (CR), partial response (PR), and non-response (NR) according to the dynamic contrast-enhanced (DCE) MR findings after treatment. Results: ADC values of areas occupied by IGM (0.933±0.317x10-3 mm2 /sec) were lower than contralateral normal parenchyma (1.259±0.423x10-3 mm2 /sec). Twenty-two (22.22%) of the lesions were in the NR group, 30 (30.30%) in the PR group, and 47 (47.47%) in the CR group. There was no significant difference between the pre-treatment ADC values in NR, PR, and CR groups (p=0.228). There was a significant difference between the pre-treatment and post-treatment ADC values in the PR groups (p=0.001). Conclusion: DW MR imaging in IGM is a useful method to monitor the response to treatment. However, it is not successful in predicting response to treatment. [ABSTRACT FROM AUTHOR]

The clinical and radiological findings of idiopathic granulomatous mastitis (IGM) can mimic breast carcinoma and several benign inflammatory breast diseases. The ultrasonographic (US) findings are important for the diagnosis. The purpose of our study was to discuss the radiological findings of idiopathic granulomatous mastitis and to analyze the socioeconomic status of patients to contribute to the etiology. A total of 93 patients with histopathological diagnosis of idiopathic granulomatous mastitis were included in the study. We recorded the radiological findings, the frequencies of involving quadrants, accompanying abscess, body mass index (BMI), breastfeeding history, number and age of children, and information indicating socioeconomic status such as monthly income, education level, and living area. Ultrasonography showed tubular hypoechoic masses in all breasts, cutaneous fistula in 50% breasts, abscess formation in 40.6%, and axillary lymphadenopathy in 40.6%. Doppler ultrasonography, mammography (MG), and magnetic resonance imaging (MRI) findings were nonspecific. According to the survey forms, 94.1% of the patients had moderate-low socioeconomic status; 80% of them lived in small towns, rural, or suburbs. Patients who had at least one child that is 6 years old or younger were 78.8% of all. As a result, the sonographic findings together with the information of anamnesis suggest us the diagnosis of idiopathic granulomatous mastitis. We particularly evaluated socioeconomic status. We think that low socioeconomic status may disrupt immunity as a stress factor and initiate idiopathic granulomatous mastitis due to the autoimmune background of the disease. [ABSTRACT FROM AUTHOR]

Steroid therapy is known to be effective against granulomatous mastitis. We aimed to compare the efficacy of local versus systemic steroid administration in patients with idiopathic granulomatous mastitis. This prospective cohort study included 58 patients who had either local (n = 42) or systemic (n = 16) treatment due to granulomatous mastitis between 2015 and 2019. Recurrence rates were determined as per ultrasound and magnetic resonance imaging examinations and the rate of side effects was evaluated as per patient complaints and physical examinations at the end of a 2-year follow-up period. Median doses of 140 mg and 3810 mg were administered to the local and systemic group, respectively. Six (14.3%) patients in the local treatment group and 13 (81.3%) in the systemic treatment group had steroid-related side effects. The local treatment group had significantly fewer side effects than the systemic treatment group (P < 0.001). The recurrence rates were similar in both groups (P > 0.05). Local steroid injection was as effective as systemic steroid therapy. Compared to systemic therapy, local steroid administration can be considered as a new therapeutic protocol with a lower dose and side effect rate. [ABSTRACT FROM AUTHOR]

Objective: To explore the application values of deep-learning based artificial intelligence (AI) automatic classification system, on the differential diagnosis of non-lactating mastitis (NLM) and malignant breast tumors, via its comparation with traditional ultrasound interpretations and the following interpretation conclusions made by the sonographers with various seniorities. Methods: A total of 707 patients suffering from breast lesions (475 malignant breast tumors and 232 NLM), were selected from the following three medical centers, including Zhejiang Cancer Hospital, Hebei Province Hospital of Traditional Chinese Medicine, and Yantai Affiliated Hospital of Binzhou Medical University, and the time period was set from April 2020 to September 2021. All selected cases firstly accepted the routine breast ultrasound diagnosis, followed by the interpretations from a senior sonographer with more than 15 years of work experience, and an intermediate-aged sonographer with more than 5 years of work experience, independently. Meanwhile, a third physician also interpreted the same ultrasound images by deep learning-based AI automatic classification system, independent of the interpretation results from the previous two physicians. The kappa test was performed to evaluate the consistency between the conventional ultrasound interpretation results and pathological results interpreted from physicians with different working experiences. Results: In total, 475 cases of malignant breast tumors (512 nodules) and 232 cases of NLM (255 nodules) were pathologically diagnosed. The accuracy, sensitivity, and specificity of conventional ultrasound interpretations vary from different sonographers with different working experiences. The accuracy, sensitivity, and specificity for intermediate-aged sonographers and senior sonographers were 76.92% (590/767), 84.71% (216/255), and 73.95% (374/512) and 87.35% (670/767), 86.27% (220/255), and 87.89% (450/512), respectively (P<0.001). In contrast, if the threshold was set as 0.5, the accuracy, sensitivity, and specificity from deep learning-based AI automatic classification system were 83.00%, 87.20%, and 85.33%, separately, and the area under the curve was 92.6. The results of the kappa consistency test indicated that the diagnosis results from the image interpretations by senior physicians and deep-learning based AI automatic classification system showed high consistency with postoperative pathological diagnosis results, and the kappa values are 0.72 and 0.71, respectively, with the P-value of less than 0.001. In contrast, the consistency between the image interpretation results from intermediate-aged physicians with less working experience, and postoperative pathological diagnosis results, seemed to be relatively lower, with a kappa value of only 0.53 and P-value of less than 0.001. Conclusions: The deep learning-based AI automatic classification system is expected to become a reliable auxiliary way to distinguish NLM and malignant breast tumors due to its high sensitivity, accuracy, and specificity. [ABSTRACT FROM AUTHOR]

Idiopathic granulomatous mastitis (IGM) is a rare benign infectious disease of the breast, commonly presenting with a unilateral breast mass. Since GM's clinical presentation and imaging can be very similar to breast cancer, diagnosing GM can be challenging. So far, various reports have demonstrated the probable correlation and co‐occurrence of granulomatous mastitis and breast cancer. This report presents a 38‐year‐old female with invasive ductal carcinoma, previously diagnosed as IGM. [ABSTRACT FROM AUTHOR]

Granulomatous mastitis (GM) is a rare, chronic, benign inflammatory disease of the breast. Here, we present a rare case of GM caused by brucellosis and present the first review to compile the cases in the literature. The diagnosis was confirmed by the patient's serological and histopathological results. The patient was successfully treated with doxycycline+rifampicin combination therapy for six weeks. In conclusion, infectious agents, especially brucellosis, should be considered in the differential diagnosis of GM in endemic regions. Diagnostic methods, such as tissue culture and serological tests, should be used to detect possible infectious agents if necessary.

Objective: The aim of this study is to investigate the relationship between post-treatment radiological findings and recurrences in idiopathic granulomatous mastitis (IGM)., Methods: Clinical data, ultrasound (US) and magnetic resonance imaging (MRI) examinations of 160 patients with IGM (mean age 34.6±7 years; range 20-56 years) who received only steroid or steroid+surgical treatment were evaluated retrospectively. Patients were grouped as radiological complete response (RCR) or radiological incomplete response (RIR)., Results: Only in the steroid group, 79 (54.1%) patients were in the RCR group and 67 (45.9%) patients were in the RIR group. Recurrence occurred in 42 (26.3%) patients, 27 (16.9%) in the same breast and 15 (9.4%) in the contralateral breast. Most of the recurrences in the same breast had residual lesions up to recurrence (74.1%)., Conclusion: Residual lesion after treatment is a risk factor for recurrence, and treatment can significantly reduce recurrences until the lesions disappear. The lesion size on MRI after treatment is not associated with recurrence., Competing Interests: No conflict of interest was declared by the authors.

Inflammatory mastitis of unknown etiology includes the entities periductal mastitis and idiopathic granulomatous mastitis. These relatively uncommon processes usually affect women of childbearing age. They usually present as a palpable mass that is painful on palpation. These lesions have an insidious clinical course and are difficult to diagnose. In some cases, they can resemble malignant disease, especially in some very developed cases where they can resemble inflammatory carcinoma. When considered all together in the appropriate clinical context, the magnetic resonance imaging signs enable us to approach a specific diagnosis. These entities share clinical and radiological characteristics with malignant processes, so biopsies are fundamental to rule out malignancy., (Copyright © 2023 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)