Exploring the pathogenesis of idiopathic granulomatous mastitis based on the prolactin theory

Prolactin(PRL),as a cytokine,plays a variety of multidirectional roles in immunity and inflammation.An autoimmune condition known as idiopathic granulomatous mastitis(IGM)involves many inflammatory cells and cytokines.PRL links neuroendocrine and immune systems and plays an active role in the inflammatory and immune processes.Based on the theory of PRL and combined with the latest research review at home and abroad,this paper aims to review the mechanism of action of PRL on IGM from the aspects of various inflammatory cells,cytokines and pathways,revealing the influence of PRL theory on IGM and the mechanism of action,so as to effectively control inflammation in the long-term.

A qualitative research of idiopathic granulomatous mastitis patients

Objective To thoroughly investigate the genuine emotional experience of patients with idiopathic granulomatous mastitis(IGM)pre-and post-treatment.Methods A purposive sampling method was adopted to select 13 patients with idiopathic granulomatous mastitis(IGM)as study objects during Feb to Dec 2016 who were all from the Department of Breast Surgery,the first affiliated hospital of Xiamen University.In addition,hermeneutic phenomenological method was performed in different ways including face-to-face interview,semi-structured interview,indepth interview,live recording and subject analysis of these collected data in hermeneutics rota⁃tion principle.Results The genuine emotional experience of patients with idiopathic granuloma⁃tous mastitis(IGM)pre-and post-treatment could be summarized into six subjects,through the thoroughly analysis of interview data,including change of sleep state,fatigue,lack of knowledge of disease,difficult to adapt to treatment state,worries and fears,and positive views of prosthesis implantation.Conclusion Lifestyle change among patient was prevalent pre-idiopathic granulo⁃matous mastitis,and patient always suffered from negative emotions and lack of disease knowl⁃edge once developed it.Therefore,it would demand medical staff to be committed to health edu⁃cation,communication with patients,and discovery problems in the first time.Moreover,posi⁃tive pertinent measures were appealed to improve confidence to overcome the suffering,and to ease or eliminate the negative emotion for recovery promotion.

Management of granulomatous lobular mastitis: an international multidisciplinary consensus(2021 edition)

Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence.Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions,etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology.The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidencebased consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.

Clinicodiagnostic management and bacteriological etiology of non-puerperal mastitis in the population of Southern China

This study aimed to describe the clinicopathologic characteristics of non-puerperal mastitis and to investigate spectrum of organisms causing it in the population of Southern China.We retrospectively registered 364 female patients with histological confirmation of inflammatory disease of the breast in the non-lactational phase,who were admitted to our institution over an 11-year period(2005–2016).Clinical,laboratory,and radiographic imaging features,as well as their bacteriological etiology,were analyzed in detail.In this study,117 patients were diagnosed with periductal mastitis(PDM)/mammary duct ectasia(MDE)and 247 patients were diagnosed with idiopathic granulomatous mastitis(IGM).There were significant differences in terms of mean age of onset,menstruation period,and menstruation history.Nipple discharge,inverted nipple,and the ratio of abscess and fistula were more spontaneous in women with PDM/MDE compared to IGM.The inflammatory biomarkers including leukocyte count,neutrophil percentage,and highsensitivity C-reactive protein in PDM/MDE group were significantly higher than IGM group.For bacteriological etiology,the most commonly isolated organism was Corynebacterium kroppenstedtii(C kroppenstedtii)in the IGM group and Staphylococcus in the PDM/MDE group.The study shows that the combination of demographic characteristics and clinicopathological characteristics was helpful in differential diagnosis of PDM/MDE and IGM.IGM can be associated with C kroppenstedtii,providing a possible effective therapeutic and preventive method by targeting this kind of bacilli.