Clinical Characteristics Of Chronic Mastitis And Clinical Observation On Antituberculosis Therapy

Chronic mastitis is a kind of the breast benign disease with the incidence increased year by year.The cause and Pathogenesis are still not clear,and there is no uniform specification treatment.some studies showed that differences between different pathological types of chronic mastitis in clinical features.However,diagnosis is still depends on pathological result.In clinical,the surgical treatment and medication are both so important.This project aims to give an initial discussion about the issues mentioned above.1.Clinical characteristics and surgical treatment about chronic mastitisMaterials and methods:The study included 259 hospitalized patients with chronic mastitis in Department of Breast Surgery,Southwest Hospital,from February 2003 to November 2015.According to pathological findings,they were divided into granulomatous mastitis(GM)group(n= 148)and plasma cell mastitis(PCM)group(n= 111).The clinical data including clinical features and surgical options were compared between two groups.Statistical analysis: data was analyzed to compare the recurrence rates.Measurement data was using SPSS version 19.0.And were processed using independent sample t test and rank sum test,count data were processed using chi-square test,Kaplan-Meier survival curve was used to analyze the recurrence interval.ResultsThe average onset age was(30.1 ± 6.9)years in PCM group,(32.7 ± 7.8)years in G M group(t = 2.8,p= 0.005).The distribution of onset age showed a statistical difference(2?= 10.4,p = 0.006).Most of the chronic mastitis patients were 26 to 40 years old.The patients with single mass as the main clinical manifestations of patients accounted for 72.3% in GM group and 52.3% in PCM group respectively.The main clinical manifestations of type distribution between the two groups was significantly different(2?= 13.7,p= 0.003).There were 105 cases(70.9%,105/148)with the distance from lesion to nipple?2 cm in GM group and 93 cases(83.8%,93/111)in PCM group,and the difference was statistically significant(2?= 5.8,p = 0.016).There were 101 patients without inverted nipple(68.2%)in GM group,54 cases(48.7%)in PCM group,suggesting a statistically difference(2?= 10.1,p= 0.001).previous use of antibiotic and hormonal drugs in PCM group more frequently.(2?= 4.9,p= 0.027).There was no significant difference between two groups in terms of,lesion location and operation frequency distribution(2?= 4.9,p= 0.027;2?= 7.3,p= 0.198;2?= 3.9,p= 0.139).In all patients,38 cases received incision and drainage,186 received mass or local excision and 35 received mastectomy,and the recurrence rate was 78.9%(30/38),55.4%(103/186)and 0 respectively,indicating a significant difference(2?=49.7,p=0.000)The interval from operation to recurrence was 66.0 d in patients receiving incision and drainage,92.0 d in patients receiving mass or local excision,indicating a significant difference(Log Rank=4.9,p=0.030).Conclusions PCM has lower onset age than GM,while both have single mass as main clinical manifestation.PCM lesions are mostly located within 2 cm from the nipple.The efficacy of mass or local excision is superior to drainage in chronic mastitis.2.Efficacy of drug therapy in chronic mastitisMaterials and methods:Totally 42 chronic mastitis patients in Breast Disease Center of Southwest Hospital from May 2014 to March 2016 were divided into two groups according to pathological findings for a prospective study: plasma cell mastitis(PCM)group(n= 11)and granulomatous mastitis(GM)group(n= 31).The patients in two groups were treated with isoniazid 0.3 g,rifampicin 0.45 g and ethambutol 0.75 g,once per day.The patients were required to accomplish the questionnaire and etiological examination.ResultsThe duration of therapy was 1-14 months(mean 6.7 months).Six cases were cured and MRI confirmed no recurrence in postoperative three months.Four patients had recurrence one month after drug withdrawal,and relieved after anti-TB treatment.Forty-two patients showed remission.Tissue samples and pus specimens from 21 cases were detected,indicating no bacterium,mycobacterium tuberculosis,or non-tuberculous mycobacteria in culture.ConclusionsTriple anti-TB drugs(isoniazid,rifampicin and ethambutol)are safe,practical and effective for conventional treatment of chronic mastitis.