False Alarms: The Intriguing Cases of Granulomatous Mastitis Mimicking Malignancy along with Review of the Literature

Abstract

Background: Granulomatous mastitis is a rare and challenging condition that can mimic malignancy in the breast. This condition often presents with clinical and radiological features that overlap with those of breast cancer, making it difficult to differentiate between the two based solely on clinical assessment. Aims and Objective: The objective of this study is to highlight the diagnostic dilemmas, the clinico-pathological profile of such cases and what enables a correct diagnosis in such cases. MATERIALS AND METHODS: A retrospective study of 5 patients with histologically proven granulomatous mastitis attending OPD/IPD at a tertiary care center in south India during a period of 18 months from Jan 2022 – Jul 23. We present five cases of granulomatous mastitis highlighting the inconsistency of the clinical, imaging and initial biopsy findings, briefly review the relevant literature and discuss the challenges associated with its diagnosis. Results and Conclusion: This study highlights the importance of awareness of granulomatous mastitis and its clinicopathological characterstics. The study also emphasizes that a multidisciplinary approach involving Surgeons, radiologists, pathologists, and medical oncologists is crucial to accurately diagnose and manage this condition. Review of literature revealed few studies highlighting the clinic-radiological and histopathological profile of such cases of granulomatous mastitis mimicking malignancy however such studies are far less and encompass only isolated single case reports or occasional series of 2-3 cases. To our knowledge this is one of the largest case series with 5 cases highlighting the clinicopathological details and the diagnostic dilemmas.

Keywords

• cystic neutrophilic mastitis
• granulomatous mastitis
• mammography
• perilobular mastitis