Granulomatous Lesions of the Breast

	Tweet

Granulomatous lesions of the breast are rare. They can be secondary to systemic conditions (sarcoidosis), infections (mycobacterium, fungal), or reactions to foreign material (silicone, narcotics).

Clinical Features
A detailed history may point in the direction of the diagnosis. Clinical examination usually reveals a palpable, firm mass in the breast.

Radiology
Depending upon underlying etiology, there may be mammographic changes of an ill-defined lesion. Frequently, these are associated with coarse calcification.

Pathology
The pathology of specific granulomatous infections or conditions such as Sarcoidosis or Wegeners granulomatosis is similar to that seen for these conditions in other sites.

Idiopathic granulomatous mastitis and silicone mastitis merit special mention.

Microscopic Appearance
Idiopathic granulomatous mastitis is a granulomatous lesion centered around ducts and lobules. No caseation or noncaseous necrosis is seen and no foreign material or pathogens are present within the lesion. Occasional small microabscesses may be present.

Silicone mastitis has a histologic appearance similar to that of fat necrosis. There are foamy macrophages and occasional multinucleate giant cells arranged in a random fashion, but poorly formed granulomata may be present.

The silicone may be apparent as highly refractile, irregular particles both within the phagocytic cells and lying free in the extracellular location.

Management
No active treatment is required once the diagnosis has been established histologically. If in doubt, excision is performed.

A.D. Purushotham, P. Britton and L. Bobrow
A prospective study of benign breast disease and the risk of breast cancer. JAMA 2002

References

RELATED STORIES:
HRT for Management of Menopause   Surveillance Options for Individuals with BRCA1 or BRCA2 Mutations   Mastodynia   Clinical Aspects of BRCA-Associated Breast and Ovarian Cancer   Technology Development Process   Breast Imaging   Fibromatosis of the breast   Chemotherapy in the Adjuvant Setting   Tumor-related factors   Mammary-Duct Fistula   Developing Technologies for the Early Detection of Breast Cancer   Tamoxifen and the Risk of Contralateral Breast Cancer: Role as a Chemopreventive Agent   Technology dissemination   Nipple Discharge   Nipple Problems and Discharge   Breast Imaging Summary   What measurable risk factors are associated with breast cancer?   Hereditary Breast Cancer Summary   Fat Necrosis   Breast Abscess   Special Clinical Forms of Breast Cancer   Chemotherapy - Breast Cancer Palliative Treatment

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]