1
|
Zhang Y, Zhang R, Sun C, Meng D, Chen L. Non-lactational mastitis with multiple sinus wounds treated by integrated traditional Chinese and Western medicine. J Wound Care 2024; 33:S4-S7. [PMID: 38843046 DOI: 10.12968/jowc.2022.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
OBJECTIVE Non-lactational mastitis (NLM) is a benign inflammatory disease of the mammary gland, with pain, swelling and redness as the main clinical manifestations. There is no unified and effective standard treatment plan for this disease at present. In addition to breast cancer, non-lactational mastitis is also becoming a presenting complaint in an increasing number of outpatients at the authors' clinic. This case report summarises the treatment and management of a 35-year-old female patient with NLM complicated with multiple sinus wounds after surgery. METHOD The patient was treated as follows, with: timely debridement according to the local condition of the wound, with manual compression to drain exudate from the sinus wound; selected wound dressings according to their performance and characteristics to fill the sinus tract for drainage and infection control; psychological care of the patient and their family to ensure that patients actively participate in the treatment; family support to the patient to deal with negative emotions; integrated traditional Chinese and Western medicine to prevent/manage infection; dietary care and control; posture management and health education to facilitate the patient's wound healing process. RESULTS After local management with systemic treatment and management using integrated traditional Chinese and Western medicine, the wound healed after 46 days, with no recurrence during a follow-up period of one year. CONCLUSION As shown in this case report, the wound should be cut and drained as soon as possible in order to prevent obstruction of the sinus drainage. Modern wound dressings are selected for the 'external' treatment of local wounds. Integrated traditional Chinese and Western medicine may help in systemic therapy of the whole patient.
Collapse
Affiliation(s)
- Yinhua Zhang
- The Affiliated Hospital of Jiangnan University Wuxi, Jiangsu 214000, China
| | - Ranran Zhang
- The Affiliated Hospital of Jiangnan University Wuxi, Jiangsu 214000, China
| | - Chunlei Sun
- The Affiliated Hospital of Jiangnan University Wuxi, Jiangsu 214000, China
| | - Dong Meng
- The Affiliated Hospital of Jiangnan University Wuxi, Jiangsu 214000, China
| | - Ling Chen
- The Affiliated Hospital of Jiangnan University Wuxi, Jiangsu 214000, China
| |
Collapse
|
2
|
Xu Y, Da B, Zhao F, Gao M, Xue L, Zheng H, Shi H, Hou L, Miao S, Liu X, Wang Y, Xu H. Corrective surgery for nipple depression in patients with plasmacytic mastitis - A single-center experience. Front Med (Lausanne) 2023; 10:1156628. [PMID: 37089608 PMCID: PMC10118005 DOI: 10.3389/fmed.2023.1156628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 04/25/2023] Open
Abstract
Background Plasma cell mastitis (PCM) is a complex breast disease in the clinic. Currently, there are no unified diagnostic criteria for the disease and no standard treatment methods. The effects of hormone, Conventional Chinese medicine and other treatments are uncertain, with long treatment duration and notable side effects. Surgery is the preferred treatment, but the recurrence rate after conventional surgery is very high, which may be related to depression of the nipple. This study aimed to evaluate the efficacy of a novel corrective procedure in patients with cellular mastitis and depressed nipples. Methods Patients with PCM who received surgical treatment in the Third Medical Center of PLA General Hospital from January 1996 to January 2018 were retrospectively analyzed. According to the presence or absence of nipple depression before surgery, the patients were divided into the nipple depression group and the non-nipple depression group. In the nipple depression group, patients were subdivided into a novel corrective surgery group ("one" suture or half pocket suture) and a conventional corrective surgery group (oil yarn traction valgus correction of nipple depression). Demographic, clinical, therapeutic, and postoperative relapse data were collected and analyzed. Results Compared with the patients in the non-nipple depression group, patients in the nipple depression group had a significantly higher recurrence risk after surgery (HR = 2.129 95% CI: 1.110-4.083, p = 0.023). Patients who underwent novel corrective surgery had a significantly lower recurrence risk than those who underwent conventional corrective surgery (HR = 0.363 95% CI: 0.150-0.880, p = 0.025). In addition, the novel corrective surgery significantly reduced the postoperative recurrence risk (HR = 0.088 95% CI: 0.009-0.886, p = 0.037). Conclusion How to correct nipple depression is a critical factor for postoperative recurrence of PCM, and this novel corrective surgery for nipple depression can effectively reduce the postoperative recurrence rate in patients with nipple depression.
Collapse
Affiliation(s)
- Yajun Xu
- Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bu Da
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fengxia Zhao
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Mingjuan Gao
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lihua Xue
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hao Zheng
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hongzhi Shi
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Lihua Hou
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shan Miao
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xinwei Liu
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yajing Wang
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Hong Xu
- Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Hong Xu,
| |
Collapse
|
3
|
Zheng Y, Wang L, Han X, Shen L, Ling C, Qian Z, Zhu L, Dong F, Han Q. Combining contrast-enhanced ultrasound and blood cell analysis to improve diagnostic accuracy of plasma cell mastitis. Exp Biol Med (Maywood) 2021; 247:97-105. [PMID: 34632855 DOI: 10.1177/15353702211049361] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Plasma cell mastitis is a benign suppurative disease of the breast, lack of specific clinical manifestations, which is easy to be misdiagnosed and mistreated, often confused with mastitis, breast cancer (BC), and other diseases. Thus, we aimed to establish a combined model of promoting diagnostic accuracy of plasma cell mastitis by contrast-enhanced ultrasound (CEUS) patterns and routine blood cell analysis. Eighty-eight plasma cell mastitis, 91 breast cancer, and 152 other benign breast diseases' patients grouped according to pathological diagnosis underwent CEUS and blood cell analysis examination; 100 healthy female donors were involved. All the plasma cell mastitis and breast cancer patients presented hyperenhancement of CEUS breast lesions compared with others. The majority of plasma cell mastitis (65/88) showed perfusion defect of CEUS patterns with smooth edge (56/65) and multiple lesions (49/65); in contrast, fewer breast cancer patients (30/91) displayed perfusion defect. White blood cell count (WBC), neutrophils, and neutrophils/lymphocytes ratio of blood cell analysis in plasma cell mastitis patients increased significantly compared with other patients (P < 0.0001). Combining perfusion defect of CEUS patterns and WBC yielded an area under the receiver operating characteristic curve of 0.831, higher than single 0.720 and 0.774, respectively. The cut-off value of WBC (7.28 × 109/L) helped remaining 65.2% (15/23) atypical cases to be correctly diagnosed as plasma cell mastitis, not misdiagnosed as breast cancer. In conclusion, CEUS presented a clear perfusion defect pattern of plasma cell mastitis lesion for the first time. A precise WBC by routine blood cell analysis test can assist CEUS examination in the differential diagnosis of plasma cell mastitis and breast cancer. It is a promised combination for laboratory diagnostic of PCM.
Collapse
Affiliation(s)
- Yan Zheng
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Lin Wang
- Center of Clinical Laboratory, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215000, China
| | - Xiu Han
- Center of Clinical Laboratory, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215000, China
| | - Lin Shen
- Suzhou Municipal Hospital, Suzhou 215000, China
| | - Chen Ling
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Zhongping Qian
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Lin Zhu
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Fenglin Dong
- The First Affiliated Hospital of Soochow University, Suzhou 215000, China
| | - Qingzhen Han
- Center of Clinical Laboratory, Dushu Lake Hospital Affiliated to Soochow University, Suzhou 215000, China
| |
Collapse
|