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Granulomatous mastitis is a rare condition in which the breast becomes inflamed, developing a mass of tissue that is sometimes mistaken for a cancerous growth. Diagnosis is complicated by the fact that the condition mimics breast cancer, which means that a healthcare professional may require several different tests to confirm a diagnosis and decide on the best treatment plan. This condition most commonly appears after a woman has a child, emerging usually about two years after the pregnancy, although this is not always the case.
A woman with granulomatous mastitis may experience discharge from the breast, along with tenderness and inflammation, which can cause the breast to feel hot to the touch. If the condition is allowed to progress, the breast can become wrinkled and pitted as the mass continues to grow inside.
During a breast exam, a medical professional will usually be able to feel a mass inside the breast. This mass is actually a granuloma, a spontaneous collection of immune cells, not a tumor, but it can feel quite similar. Women may also find the mass on a breast self-exam. The healthcare professional may recommend testing, such as an imaging study to look inside the breast and a biopsy to examine cells taken from the mass of tissue. The biopsy result will show that the mass is granulomatous in nature.
Treatment for granulomatous mastitis can include surgery to remove the granuloma and drain the wound. The patient is also given steroids to combat the inflammation. If the condition resolves successfully after treatment, there is a 50% chance that it will recur. One of the major problems with the treatment of this condition is that long-term steroid use can have serious side effects, but the only way to successfully get rid of the issue is to put a patient on a long course of steroids. Treatment must balance the need to resolve the inflammation with a desire to avoid causing complications for the patient.
The cause of granulomatous mastitis is not well understood. Some researchers have suggested that it may be simply a more extreme form of the mastitis or inflammation of the breast that some breastfeeding women experience. Others suggest that it may be connected with the use of hormonal contraception, since it often appears after breastfeeding is concluded and a woman has started taking hormones to prevent an additional pregnancy.