The Optimal Time And Treatment Of Plasma Cell Mastitis

Objective: To investigate the cure rate and recur rate in different Plasma cell mastitis(PCM)gruops characterized by clinical features.Each group received different therapy according to their clinical type.Thus to illustrate the operation selection and timing of PCM.Methods: A retrospective observation of 178 female patients with PCM was conducted at the second affiliated hospital of Chong Qing medical university between January 2006 and December 2015.178 PCM patients were devided into four groups according to the clinical characteristics.PCM patients presented with acute inflamatory syndromes were received antibiotic therapy for one weeks before sugery,and in some severe cases,anti-anaerobic therapy was used in combination with dexamethasone.Mass type acute inflammatory PCM(n=89),received lumpectomy or local anaplasty or quadrant resection.Mass type chronic inflammatory type PCM(n=47),conduced breast regional excision or quadrant resection.Abscess type PCM(n=36),choosen incision drainage or excision.PCM patients accompanied with nipple retraction were conducted nipple retraction correction at the same time.The number of patients followed for 1 to 3 years was 163,median follow-up time was 22 months.The treatment,cure rate and recur rate were recorded among each group.Results:(1)The cure rate and recur rate in mass type acute inflammatory PCM group is 97.75%(87/89)and 2.25%(2/89).(2)The cure rate and recur rate is 93.62%(44/47)and 6.38%(3/44)in mass type chronic inflammatory PCM group.(3)Incision drainage or excision therapy was adapted in abscess type PCM.The cure rate and recur rate is 21.43%(3/14)and 78.57%(11/14)in incision drainage subgroup,90.91%(20/22)and 9.01%(2/22)in excision subgroup.(4)The cure rate and recur rate is 83.33%(5/6)and 16.67%(1/6)in fistula type PCM.Mass type Acute inflammatory PCM has the higher cure rate compared with mass type chronic inflammatory PCM(97.75% vs 93.62%,p=0.002),and antibiotics therapy is effective in this period,while surgery is suggested in chronic mass type PCM.Early diagnosis and treatment is crucial to PCM,comprehensive therapy should be adopted in different clinical type of PCM.