Clinical Characteristics Of Non-lactational Mastitis And Identification Of Mycobacteria

BackgroundNon-lactational mastitis(NLM)are common benign breast disease.The incidence is increasing these years.The mainly pathological types are granulomatous lobular mastitis(GLM)and plasma cell mastitis(PCM).The manifestations of NLM are breast lumps,skin irritation,pain,sinus or fistula formation.It is difficult to distinguish GLM from PCM for their similar manifestations.As NLM has a deferred course of disease,it influences the daily life and work of patients severely.Nowadays,research shows that NLM may be associated with mycobacterial infection and antimycobacterial therapy is effective.ObjectiveThis study was designed to analyze the differences and similarities in clinical characteristics between GLM and PCM and to explore the relationship beteewn NLM and mycobacteria infection.MethodsA retrospective analysis was carried out in 43 patients with GLM and 50 patients with PCM in the First Affiliated Hospital of Nanchang University.The clinical characteristics were compared between the two groups.HE staining,acid-fast staining,DNA extraction,amplification of mycobacterial,DNA electrophoresis,reverse dot blot were performed on the pathological section.Results1.The regional distribution of NLM patients with different pathological types was different,and the proportion of patients from rural areas was higher in GLM group than that in PCM group(P<0.05).The age between GLM and PCM had nosignificant difference [(31.8 ± 7.6)vs(34.1 ± 9.5),P> 0.05].The duration of GLM group was longer(P <0.05).2.Compared with the PCM group the times of delivery were more,the duration is longer,the size and number of breast mass are bigger and lower limbs erythema occurrence rate is higher in GLM group(P <0.05).The ratio of congenital inverted nipple was higher in PCM group(24.0% vs 4.7%,P <0.05);The breast local manifestations,such as redness,pain,abscesses,ulceration were similar between the two groups(P> 0.05).There was no significant difference in white blood cells between the two groups(P> 0.05).3.Acid-fast staining were negative in all patients.The positive rate of mycobacteria DNA reverse dot blot was 4.7% in the GLM group.4.The overall recurrence rate of NLM was 7.5%,which was 9.2% in group GLM and 6% in group PCM,and there was no significant difference between the two groups(P> 0.05).Mean follow-up was 20.5 months.Conclusions1.Compared with the PCM group,the GLM group had higher proportion of rural areas,longer delivery times,longer course of disease,larger masses,and higher incidence of erythema.The incidence of nipple depression was higher in group PCM than in group GLM.There was no significant difference between the two groups in terms of age of onset,history of abortion,local skin changes and white blood cell count.2.Mycobacterium infection rate is low in NLM and mainly occurred in the GLM group.3.The overall recurrence rate of NLM was 7.5%,and the recurrence rate of GLM and PCM two groups was similar with the mean follow-up of 20.5 months.