Conservative treatment of granulomatous mastitis

Generally speaking, after suffering from granulomatous mastitis, many patients are very worried about having their breasts removed. In fact, if the patient's condition is not very serious, conservative treatment methods can also help the patient recover. So, how to carry out conservative treatment of granulomatous mastitis? This requires the formulation of specific treatment plans based on the conditions and manifestations of different patients.

First, granulomatous mastitis is currently considered to be related to autoimmunity and is a granulomatous lesion of the mammary gland with non-caseous necrosis limited to the lobules. Clinically, the case mainly occurs in women of childbearing age with a history of childbearing, and a few occur during lactation and pregnancy. At the beginning of the disease, there is often a sudden discovery of a breast lump, accompanied by pain, redness and swelling of the skin, and some nipple discharge may also be seen. In some cases, the disease progresses slowly, showing a persistent "hard lump" manifestation. In some cases, the lump increases rapidly, or is accompanied by redness, swelling, ulceration and pus discharge. Some patients may experience nodular erythema, swelling, pain and low-grade fever in the joints of the upper and/or lower limbs during the acute phase. With the control of local inflammation, the symptoms of joint erythema, swelling and pain will be relieved or disappear.

Currently, there is no unified treatment plan for granulomatous mastitis internationally. Surgery, steroid hormones, immunosuppressants, anti-tuberculosis drugs, traditional Chinese medicine or palliative care have all been reported to be effective, but reports of complete cure without recurrence are relatively rare. The treatment of granulomatous mastitis requires individualized clinical treatment.

The specific treatment method is different according to different symptoms.

For example: for patients in the early stage of the disease, with lumps and pain as the main symptom but no clear abscess, conservative treatment is mainly used, including oral Chinese medicine based on syndrome differentiation and local Chinese medicine external treatment, and combined use of antibiotics for patients with severe inflammation. For some patients, the lumps disappear and the disease is cured after treatment, and there is no recurrence of the disease during follow-up several years later. For some patients, the lumps do not disappear completely after treatment, and smaller lumps still remain. In this way, surgical treatment can be considered after the inflammation is controlled. This also ensures the aesthetics of the breast to the greatest extent.

For patients with ulcers and pus discharge, relevant examinations are combined to observe the sinus tracts and lesions in the breast. For those with poor drainage, expansion surgery is performed, and local Chinese medicine dressings are changed after surgery combined with oral treatment based on syndrome differentiation. For those with smooth drainage, local Chinese medicine dressings are changed combined with oral treatment based on syndrome differentiation. After the sinus tract is reduced and the breast defect is filled through treatment, surgery is performed to remove residual lesions, eliminate the source of the disease, shorten the course of the disease, and at the same time take into account the beauty of the breast.

Therefore, it is not terrible to have granulomatous mastitis, but it requires "the right medicine"!

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