Meagan E Brennan1, Melissa Morgan2, Ghaith Bahjat Heilat3, Kavitha Kanesalingam4. 1. FRACGP, FASBP, PhD, Senior Staff Specialist, Westmead Breast Cancer Institute, Westmead Hospital, NSW; Clinical Academic, School of Medicine Sydney, University of Notre Dame Australia, NSW; Clinical Associate Professor, Northern and Westmead Clinical Schools, School of Medicine, Faculty of Medicine and Health, University of Sydney, NSW. 2. BSc (Hons), MCom, Patient Advocate, Westmead Breast Cancer Institute, Westmead Hospital, NSW. 3. MD, JBGS, Fellow in Oncoplastic Surgery, Westmead Breast Cancer Institute, Westmead Hospital, NSW; Surgeon, Faculty of Medicine and Clinical Sciences, Yarmouk University, Jordan. 4. MBChB, FRCS, Fellow in Oncoplastic Surgery, Westmead Breast Cancer Institute, Westmead Hospital, NSW.
Abstract
BACKGROUND: Granulomatous lobular mastitis (GM) is a rare chronic benign inflammatory breast condition. It can present a diagnostic challenge and mimic inflammatory carcinoma. It causes significant morbidity for affected patients. OBJECTIVE: The aim of this article is to provide a clinical update and case study for general practitioners, who are usually the first to see the patient. DISCUSSION: GM is usually idiopathic. The condition presents with a large painful lump with erythema. There is often ulceration, abscess and sinus formation. Triple assessment is needed to confirm diagnosis. GM may last for 12 months or more before healing occurs. Options for management are conservative/supportive care, oral prednisone or methotrexate, or surgical excision. At present, there is no universally accepted management strategy for GM; therefore, treatment will depend on the symptoms, extent of disease and patient preferences. Supporting the patient in coping with the long-term nature of GM and the chronic discharging lesions is essential.
BACKGROUND:Granulomatous lobular mastitis (GM) is a rare chronic benign inflammatory breast condition. It can present a diagnostic challenge and mimic inflammatory carcinoma. It causes significant morbidity for affected patients. OBJECTIVE: The aim of this article is to provide a clinical update and case study for general practitioners, who are usually the first to see the patient. DISCUSSION: GM is usually idiopathic. The condition presents with a large painful lump with erythema. There is often ulceration, abscess and sinus formation. Triple assessment is needed to confirm diagnosis. GM may last for 12 months or more before healing occurs. Options for management are conservative/supportive care, oral prednisone or methotrexate, or surgical excision. At present, there is no universally accepted management strategy for GM; therefore, treatment will depend on the symptoms, extent of disease and patient preferences. Supporting the patient in coping with the long-term nature of GM and the chronic discharging lesions is essential.