Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2024; 12(21): 4748-4754
Published online Jul 26, 2024. doi: 10.12998/wjcc.v12.i21.4748
Granulomatous lobular mastitis treated by a combined internal and external treatment of traditional Chinese medicine: A case report
Tian Meng, Mei-Ling Chu, Bing Wang, Mei-Na Ye, Yi-Qin Cheng, Hong-Feng Chen
Tian Meng, Department of Breast Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Mei-Ling Chu, Bing Wang, Mei-Na Ye, Yi-Qin Cheng, Hong-Feng Chen, Department of Breast Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Author contributions: Meng T and Ye MN designed the study, provided the case presentation; Wang B, Chu ML, Cheng YQ, and Chen HF were involved in literature search; Meng T was involved in interpretation of data, writing of the manuscript and decision to submit the manuscript for publication; All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment. Written informed consent for publication of their clinical details and clinical images were obtained from the patient.
Conflict-of-interest statement: All authors declare that there are no conflicts of interest that could be perceived as prejudicing the impartiality of the research reported.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei-Na Ye, MD, Doctor, Department of Breast Surgery, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, No. 725 Wanping South Road, Xuhui District, Shanghai 200032, China. yemeina2020@126.com
Received: March 8, 2024
Revised: June 5, 2024
Accepted: June 19, 2024
Published online: July 26, 2024
Processing time: 115 Days and 6.6 Hours
Abstract
BACKGROUND

Granulomatous lobular mastitis (GLM) is a rare benign inflammatory disease of the breast and is classified under comedo mastitis in traditional Chinese medicine (TCM). The etiology of this disease is unknown, and it mainly occurs in women of childbearing age. The diagnosis depends on histopathological biopsy. At present, there is no systematic and standardized treatment plan for GLM. In the absence of evidence supporting an infectious etiology, affected patients might continue to receive multiple courses of antibiotics and unnecessary surgery.

CASE SUMMARY

A 37-year-old Chinese woman with a history of coronavirus disease 2019 infection presented with swelling and pain in the left breast. She also had erythema, nodules in the lower extremities, arthritis in both knees, cough, and headache. In the early stage of GLM, the mass was not significantly reduced by conservative treatment with internal application of TCM; hence, surgical treatment was carried out. The aim of postoperative treatment was to drain the pus, eliminate the necrosed tissue, and expand the muscles; fumigation and washing using TCM was applied.

CONCLUSION

Combined internal and external treatment with TCM, following the principle of “Prioritize internal treatment before ulceration and emphasize external treatment after ulceration” was effective in our patient with GLM. The prognosis was good. We believe that TCM offered valuable therapeutic benefits in this disease.

Keywords: Granulomatous mastitis; Traditional Chinese medicine; Erythema; Nodules in the lower extremities; Arthritis in both knees; Cough and headache; Case report

Core Tip: We focus on the treatment efficacy of combining traditional Chinese (TCM) and Western medicine for granulomatous lobular mastitis (GLM). GLM was treated conservatively with TCM in the early stages, but the disease symptoms did not significantly improve. Hence, surgery was required. Postoperatively, we drained the pus, removed decay, and dilated muscles through TCM-based fumigation and washing. The combination of TCM and Western medicine had a definite therapeutic effect on GLM and offered good prognosis. TCM offered valuable therapeutic benefits in this disease.