| Background:Plasma Cell Mastitis (PCM) is a breast suppurative disease of chronic nonbacterial infections, which has the pathologic basement of mammary ductal ectasia and plasmocyte infiltration. The main clinical manifestations included swelling of affected breast, breast pain, nipple discharge, congenital inverted nipple, masses in The areola or other parts of breast, breast abscess, fistula, axillary lymph node enlargement and so on. The course of disease is long, easy to relapse, surgical is the main treatment, but it may cause varying degrees of breast deformity, and even amastia, which cause great physical and psychological damage to patients. My mentor ZHANG Shiyun has accumulated some experience in the treatment of plasma cell mastitis. For the consideration of the influence of the shape of the breast, and to reduce the damage of recurrence after surgery, in recent years, she gradually changed from the surgical treatment to the traditional Chinese medicine treatment direction change, obtain satisfactory curative effect. But the effect and the evaluation of the breast shape were not systematically analyzed.Objective:This research is about the treatment and retrospective analysis of plasma cell mastitis patients in GUANANMEN hospital. To get to know the clinical features and treatment of plasma cell mastitis, and evalute the efficacy, treatime, breast shape after different treatment. This study may provides reference for the optimization of clinical treatment plan.Methods:We conducted the retrospective analysis of the inpatients and our patients with PCM from the Hospita, and collected the general information, diagnosis and treatment information. To evaluate breast shape, clinical effect, reoccurrence, and the period of treatment. We reviewed cases between the year of 2013 to 2015, and summarized the data. The data was analyzed by SPSS 20.0.Result:There are more female patients, the average age of onset of the disease is 33.04+6.59 years old. No significant differences in the age of menarche between female patients and and the national survey of women. Most of female were parous females. The time of onset of the disease was 1 to 4 years. In patients with an average time of 11.76 months of lactation. Seventy percent of patients come to our hospital before treatment, in which 29 patients received two or more than two treatment methods. No obvious curative effect was obtained.The course of patients was 3 days to 2 years. Most concentrated within 1-3 months, the average duration of the disease was 82.03 days. Unilateral breast disease patients for 108 cases, accounting for 93.9%, bilateral breast at the same time the incidence of 7 cases, accounting for 6.1%. There was no significant difference between the left breast and the right side of the breast. Areola of local lesions in 6 patients,34 patients with breast a quadrant lesions,39 patients with two quadrant lesions,25 patients with three quadrant lesions, the entire breast or four quadrant lesions is 11 cases.Breast lesions in the first visit to the hospital. The vast majority of patients with ipsilateral breast pain, breast swelling, mass, abscess, ulceration/sinus symptoms part or all.21 patients had no tumor, swelling, abscess, ulceration and sinus.113 patients had different degrees of breast pain. In the total number of cases, there were 65 patients with nipple depression,14 patients with nipple discharge.In 115 patients,45 patients have enlarged ipsilateral axillary lymph node lesions of breast.15 patients first visit had high temperature.10 patients had symptoms of joint pain, 7 patients had skin rash or erythema of lower limb.62 cases of patients had been examined serum prolactin in their initial visit, among them 9 patients with prolactin abnormally elevated,2 of them have nipple milk-like discharge. The serum prolactin level of patients decreased after treatment. In patients who have been cured,15 patients had been examined IgA, IgM, IgG before and after the treatment. After paired samples non-parametric rank sum test, there was no significant difference before and after IgM treatment. IgA and IgG levels were decreased after treatment than before treatment.Most of the patients received traditional Chinese medicine treatment, second is traditional Chinese medicine combined with surgical treatment, the number of patients with surgical treatment is the least. Surgical treatment of surgical incision and drainage of block resection, tumor resection, purulent infection incision and drainage.About treatment time, surgical treatment is better than the traditional Chinese medicine combined with surgery and the traditional Chinese medicine treatment only.The total effective rate was 99.1%. The difference of operation, traditional Chinese medicine and traditional Chinese medicine combined with surgery in the evaluation of curative effect is not statistically significant. In terms of the influence to breast shape, the traditional Chinese medicine treatment is superior to the operation and the combination of traditional Chinese medicine treatment, surgical treatment and traditional Chinese medicine combined with surgical treatment of breast shape does not have significant differences. |
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