Granulomatous Lobular Mastitis

Granulomatous lobular mastitis is a rare inflammatory disease of the breast. This disease usually affects women of child-bearing age or those who use oral contraceptive medication. It can be confused with breast cancer, so it is often misdiagnosed and proper treatment is delayed. The main symptoms include a palpable mass, skin or nipple retraction, and pain and swelling in the breast. Core needle biopsy is the recommended method for diagnosis and must be made in all cases, to rule-out breast cancer and other causes of granulomatous mastitis (such as infections (bacterial, fungal, mycobacterial), sarcoidosis, and other systemic granulomatous diseases). After ruling-out these diseases, the diagnosis of idiopathic “granulomatous lobular mastitis” is made. The cause is unknown, but may be autoimmune. Some cases are associated with Corynebacterium infection (when it is known as cystic neutrophilic granulomatous mastitis). There is no established treatment, but antibiotics, corticosteroids, drainage, excision, and surgical removal of the lesion have been tried with variable success.