背景:乳腺炎是乳房的炎性病症,其代表包括感染性和非感染性原因的一系列潜在病因。加重因素包括地方性感染,缺乏意识和次优的母乳喂养做法。被忽视的病例会导致发病率延长,反复发作,以及脓肿或窦道形成等并发症,导致乳房永久性毁容。其与乳腺癌的重叠临床表现需要综合的多学科方法进行诊断和治疗。
目的:主要目的是调查人口统计,放射学,乳腺炎的组织病理学特征。目标包括相关的放射学和组织病理学发现,按病因对乳腺炎进行分类,识别不同临床环境的临床和影像学模式,以增强对乳腺炎的认识。
方法:这是一项回顾性观察研究,分析临床,放射学,以及2023年2月至2024年2月期间65例乳腺炎患者的组织病理学数据。
结果:该研究包括65名患者,18至65岁,乳房疼痛是最常见的临床表现。病例分为传染性(47.6%)和非传染性(52%)。急性产褥期乳腺炎(26.15%)和肉芽肿性乳腺炎(30%)是最常见的亚型。最常见的乳房X线摄影发现是局灶性不对称。在超声波上,感染性乳腺炎表现为水肿和其他炎症变化,包括弥漫性皮肤增厚和集合;而非感染性乳腺炎通常表现为单发或多发乳腺肿块(p<0.001)。令人惊讶的是,在我们的研究中,特发性肉芽肿性乳腺炎在各种组织病理学原因中占最大比例。
结论:了解发病机制的综合多学科方法对于及时诊断和优化治疗策略至关重要。从而改善患者预后。放射成像对诊断至关重要,评估疾病程度,进行指导性干预,并监测治疗反应。
BACKGROUND: Mastitis is an inflammatory condition of the breast which represents an array of underlying etiologies encompassing both infectious and non-infectious causes. Exacerbating factors include endemic infections, lack of awareness and suboptimal breastfeeding practices. Neglected cases lead to prolonged morbidity, recurrent episodes, and complications such as abscess or sinus formation, resulting in permanent breast disfigurement. Its overlapping clinical presentation with breast cancer necessitates an integrated multidisciplinary approach for diagnosis and treatment.
OBJECTIVE: The primary aim was to investigate demographic, radiological, and histopathological characteristics of mastitis. Objectives included correlating radiological and histopathological findings, classifying mastitis by etiology, identifying the clinical and imaging patterns across diverse clinical settings to enhance the understanding of mastitis.
METHODS: This is a retrospective observational study, analysing the clinical, radiological, and histopathological data from 65 patients with mastitis between February 2023 and February 2024.
RESULTS: The study included 65 patients, aged 18 to 65 years, with breast pain as the most prevalent clinical presentation. Cases were classified as infectious (47.6%) and non-infectious (52%). Acute puerperal mastitis (26.15%) and granulomatous mastitis (30%) were the most common subtypes. The commonest mammographic finding was focal asymmetry. On ultrasound, infectious mastitis showed oedema with other inflammatory changes, including diffuse skin thickening and collections; while non-infectious mastitis typically presented as solitary or multiple breast masses (p < 0.001). Surprisingly, idiopathic granulomatous mastitis constituted the largest percentage amongst various histopathological causes of mastitis in our study.
CONCLUSIONS: An integrated multidisciplinary approach with understanding of the pathogenesis is imperative for prompt diagnosis and optimizing treatment strategies, thereby improving patient outcome. Radiological imaging is critical for diagnosis, evaluating disease extent, conducting guided interventions, and monitoring treatment response.