Inflammatory breast lesions
- Rare
- Present as red, painful breast(s)
- Most common is acute mastitis which is associated with lactation
- Inflammatory breast cancer mimics inflammation by obstruction local vasculature with emboli this causing a large erythematous breast and should be suspected in a nonlactating women with the clinical signs of mastitis
Acute mastitis
- Mostly occur in first month of nursing
- Nipple cracks make breast susceptible to infection
- Usually causes by Staph aureus or Steptococci
- Painful red breast normally accompanied by a fever
- Treated with antibiotics and complete drainage of the breast
Periductal mastitis
- Both sexes can present with a painful erythematous suareolar mass
- Thought to be infective
- Associated with smoking
- Not associated with lactation
- May result in nipple inversion due to fibrosis and scarring
- Histologically keratinizing squamous epithelium extends deep in the nipple ducts
- Keratin becomes trapped in the ducts –induces a granulomatous inflammatory reaction
- Clinical management involves removing the affected duct or any fistuka
- If there is also an infection, antibiotics are required
Mammary duct ectasia
- Generally occurs in multiparous women age 50-60
- Patients present with a periareolar mass, possibly some skin retraction and a white thick nipple discharge
- Associated with dilation of ducts and a chronic granulomatous inflammatory response
Fat necrosis
- Painless palpable mass
- Skin thickening, retraction and mammographic density
- May give a history of trauma or surgery
Lymphocytic mastopathy
- Presents with single or multiple hard, palpable masses
- Hardness of lesions can make biopsy a problem
- Most common in women with Type I diabetes or autoimmune thyroid disease
- Autoimmune disease of the breast?
- Microscopically, thickened basement membrane and collagenized stroma around atropic ducts and stroma
Granulomatous mastitis
- Causes by a variety of rare conditions
- May be due to;
- Systemic granulomatous disease (sarcoidosis, Wegener’s granulomatosis)
- Infections – particularly in the immunocompromised or when there has been breast surgery or piercing