Summary of the article.
This article discusses three types of benign breast diseases: periareolar mastitis, granulomatous lobular mastitis (GLM), and lymphocytic or diabetic mastopathy. Here is a summary:
Clinical Presentation: Recurrent abscess or sinus at the areolar margin, often in women in their 20s and 30s.
Pathophysiology: Squamous metaplasia of the central duct, causing duct obstruction and subareolar duct ectasia.
Surgical Management: Involves central duct excision, excision of the abscess site, and reconstruction of the subareolar complex.
Granulomatous Lobular Mastitis (GLM):
Clinical Presentation: Palpable breast mass, commonly in Hispanic women around 35 years old. Breast Pain, erythema and skin changes such as warmth and swelling, clear or bloody nipple discharge.
Diagnosis: Imaging (ultrasound) and core needle biopsy to differentiate from carcinoma.
Treatment: Authors recommend avoiding surgical procedures, favoring aspiration, short courses of antibiotics, and observation for milder cases.
Lymphocytic or Diabetic Mastopathy:
Clinical Presentation: Painless breast masses in premenopausal women with long-standing insulin-dependent diabetes.
Diagnosis: Core needle biopsy showing dense keloidal fibrosis and perivascular lymphocytic infiltrate.
Management: No specific interventions after confirmation; patients may develop subsequent masses requiring standard evaluation.
Periareolar mastitis is often misunderstood, requiring central duct excision for definitive management.
GLM can be challenging, and the treatment strategy focuses on less invasive approaches.
Diabetic mastopathy is associated with insulin-dependent diabetes, and diagnosis involves histopathological examination.
The article emphasizes the importance of accurate diagnosis to distinguish these benign conditions from breast cancer.
In summary, the operative management of periareolar mastitis involves specific surgical procedures, while GLM and diabetic mastopathy are managed with less invasive approaches, including observation and aspiration.