Concurrent granulomatous mastitis and invasive ductal cancer in contralateral breasts-a case report and review

Is there an association between mastitis and breast cancer? a retrospective cohort study from Germany

PURPOSE

The aim of the study was to explore the association between mastitis and subsequent breast cancer.

METHODS

This retrospective cohort study included women aged ≥ 18 years with an initial mastitis diagnosis from 315 office-based gynecologists in Germany between January 2005 and December 2021. Women without mastitis were matched to women with mastitis using propensity score matching based on age, index year, average yearly consultation frequency during the follow-up period, and coexisting diseases such as obesity, benign mammary dysplasia, hypertrophy of the breast, unspecified lump of breast, and other disorders of the breast. The 10-year cumulative incidence of breast cancer for the mastitis-cohort and non-mastitis-cohort was studied with Kaplan-Meier curves using the log-rank test. The association between mastitis and breast cancer was studied separately for four age groups with univariable Cox regression analyses.

RESULTS

In the follow-up period of 7 months to 10 years after the index date, 2.9% of mastitis patients and 2.4% of matched non-mastitis patients were diagnosed with breast cancer. A Cox regression analysis revealed a significant association between mastitis and subsequent breast cancer (HR: 1.37; 95% CI: 1.11-1.70). According to the age-stratified analyses, a strong and significant association was only observed in the age group > 50 years (HR: 1.73; 95% 1.25-2.40).

CONCLUSION

The findings of our retrospective cohort study support an association between mastitis and subsequent breast cancer diagnoses in women aged > 50 years. The pathophysiological basis and possibility of confounders however requires further investigation.

Investigation of multi-infections and breast disease comorbidities in granulomatous mastitis

Introduction

Granulomatous mastitis (GM) is an inflammatory breast disease typically caused by infection, posing diagnostic challenges. It can coexist with other breast disorders or multiple infections, which have been vaguely discussed. This study investigates the incidence of multi-infection and breast disease comorbidities in GM.

Method

The study enroled 63 females who had a confirmed diagnosis of GM. Laboratory investigations and bacterial cultures had been conducted for all the cases. The patients had undergone ultrasonography examination utilizing the LOGIQ E9 system. Core needle biopsy had been done to procure tissue samples for histopathological examination. Thorough scrutiny and assessment of patients' records were performed. The variables encompassed age at presentation, breastfeeding data, parity, smoking status, seasonal affliction, hair-washing agents, exposure to radiation, comorbidities, and clinical, ultrasound and histopathological findings.

Results

The patients' ages ranged from 24 to 50. Breastfeeding history was positive in nearly all cases (97%). The majority of cases exhibited multiparity (81%). In total, 63.5% were passive smokers. Multi-infections were detected in six cases (9.5%). Among them, B. cepacia complex and Toxoplasma gondii were identified in two cases (3.16%). Other multi-infections involved Staphylococcus epidermidis and Toxoplasma gondii, Burkholderia cepacia and S. kloosii and Toxoplasma gondii, Staphylococcus epidermis and Brucella spp., Candida spp. and Brucella spp. Histopathological analysis revealed GM comorbidities with other breast diseases in 35% of the cases.

Conclusion

Multi-infections and breast disease comorbidities may further complicate diagnosis and management of GM. The findings of this study may raise additional questions about the nature of the disease or potential complications associated with it.

Comparison of Interleukin-33 Serum Levels in Patients with Breast Cancer and Idiopathic Granulomatous Mastitis

BACKGROUND

Breast cancer (BC) is the main cause of cancer death in women. Idiopathic granulomatous mastitis (IGM), a rare chronic disease that clinically mimics breast carcinoma, and is associated with high mortality and morbidity, but an immediate and accurate diagnosis can substantially decrease these rates. Expressed by numerous human tissues, interleukin-33 (IL-33) has an inductive role in the network of pro-inflammatory cytokines. The aim of this study was to investigate the serum levels of IL-33 in BC and IGM patients in comparison with healthy women.

MATERIALS AND METHODS

This descriptive-analytical study was carried out on 28 patients with BC and 25 patients with IGM as the patient groups and 25 healthy volunteers with normal screening reports as the control group. Histopathological pattern of BC and IGM were confirmed by specialized pathologists. The serum concentration of IL-33 was measured using enzyme-linked immunosorbent assay (ELISA) kit according to the manufacturer's instructions.

RESULTS

The mean age of the patients with BC and IGM and the control group was 49.1, 37.1, and 36.8 years, respectively. There was no significant difference in IL-33 expression among the participants with regard to age, marital status, body mass index (BMI), and menopausal status. IL-33 assay indicated a significant difference between the BC (P=0.011) and IGM (P=0.031) groups compared to the controls, although no substantial differences were observed between the IGM and BC groups.

CONCLUSION

IL-33 can be considered a significant factor distinguishing IGM and BC patients from controls, although it cannot be applied to diagnose and differentiate BC from IGM patients.
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Benign or premalignant? Idiopathic granulomatous mastitis later diagnosed as ductal carcinoma breast cancer: Case report and review of literature

Idiopathic granulomatous mastitis (IGM) is a rare benign infectious disease of the breast, commonly presenting with a unilateral breast mass. Since GM's clinical presentation and imaging can be very similar to breast cancer, diagnosing GM can be challenging. So far, various reports have demonstrated the probable correlation and co-occurrence of granulomatous mastitis and breast cancer. This report presents a 38-year-old female with invasive ductal carcinoma, previously diagnosed as IGM.