Clinical Analysis of Misdiagnosis of Granulomatous Lobular Mastitis

ZHOU Haiyang; LI Hao; WANG Shilin; WEI Xueming; WANG Yan; ZHENG Ziyang; ZHANG Yuhui

doi:10.3969/j.issn.1002-3429.2024.06.003

Abstract：Objective To investigate the clinical features,causes of misdiagnosis and preventive measures of granu-lomatous lobular mastitis(GLM).Methods The clinical data of 18 misdiagnosed patients with GLM treated from January 2018 to December 2023 were retrospectively analyzed.Results In this group,16 patients presented with breast mass,and 2 patients presented with skin ulceration and pus.Thirteen patients were misdiagnosed as inflammatory breast cancer and 5 pa-tients were misdiagnosed as breast tuberculosis.The duration of misdiagnosis was 7-22(9.31±1.36)d.The patient misdiag-nosed with inflammatory breast cancer was diagnosed with GLM after surgical resection and pathological examination.The pa-tient misdiagnosed with breast tuberculosis had recurrence after anti-tuberculosis treatment,and underwent surgical resection.The secretions were tested by bacterial culture and pathogen testing,all of which were negative.The pathological examination confirmed the diagnosis as GLM.All patients underwent surgical treatment,the breast lesions were completely removed,and anti-infective treatment was given for 7 d after resection.Of them,14 patients took oral prednisone acetate for 30 d after sur-gery,and the other 4 patients did not take oral drugs.All the 18 patients were cured.Conclusion GLM is rare and has no typical clinical manifestations.It is more likely to be confused with breast cancer and tuberculous mastitis and misdiagnosed.It is necessary for clinicians to strengthen the knowledge of GLM,enhance the vigilance of the disease,comprehensively ana-lyze the condition,and perform the differential diagnosis carefully,so as to reduce the misdiagnosis of GLM.