Granulomatous mastitis

Case contributed by Hanna Damtew Taddese
Diagnosis almost certain

Presentation

Chronic right breast pain and swelling.

Patient Data

Age: 30 years
Gender: Female
mammography

There are associated groups of round calcifications due to the asymmetrical density of the upper outer quadrant of the right breast without a distinct margin.

No architectural distortion. The right nipple is retracted.

Ultrasound-guided FNAC was performed and suggested granulomatous mastitis.

Case Discussion

Granulomatous mastitis is a rare disease occurring in young premenopausal women after their last childbirth. It is related to oral contraceptive use, breastfeeding and a possible autoimmune component. Mammography presentations are usually focal asymmetry or ill-defined breast masses. Mammography calcification is rare and reported in about 11% of the cases. The etiology is generally unknown (idiopathic). Bilateral involvement is more common in TB mastitis than the idiopathic cause.

Definitive diagnosis settled via biopsy since clinical and imaging findings are the same as malignancy and are challenging to rule out.

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