A Painful Breast Lump May Be Mistaken For Cancer When It’s Really Granulomatous Mastitis

Feeling a breast lump while doing your monthly checks or at a routine physical can instantly inspire fear and panic. Thankfully, statistics are in your favor, because 80% to 85% of breast lumps are benign.

If the lump in your breast is painful, that’s also typically good news. Most breast lumps that end up being cancerous are not painful.

If you do find a lump in your breast that hurts, it could actually be a condition called granulomatous mastitis.

What Is Granulomatous Mastitis?

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Granulomatous mastitis is a benign inflammatory breast disease that is rare, but treatable. Though it can be mistaken for breast cancer at first, it is a different condition.

It typically presents as a lump that is tender or painful, has ill-defined edges, and is firm. Other symptoms may include skin inflammation, redness, fever, an inverted nipple, and enlarged lymph nodes.

What Causes Granulomatous Mastitis?

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Most cases of granulomatous mastitis are idiopathic, meaning the cause is unknown. However, a few different conditions have been linked to the disease, like tuberculosis, sarcoidosis (an inflammatory disease), trauma, metabolic or hormonal processes, autoimmunity, and an infection with the pathogen Corynebacterium kroppenstedtii.

Idiopathic granulomatous mastitis is most common in women who are in their late 20s, 30s, and 40s who have had children. However, women who haven’t had children but are in this age group have still gotten the condition.

How Is Granulomatous Mastitis Diagnosed?

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Granulomatous mastitis typically presents as a painful mass, but other symptoms may include skin inflammation, redness, and fever. While an MRI, mammogram, and ultrasound can’t definitively prove granulomatous mastitis, both mammograms and ultrasounds can rule out similar conditions like inflammatory breast cancer (IBC) or infectious mastitis (inflammation of the milk ducts, which can be common in breastfeeding women).

If the condition persists after ruling out other conditions and prescribing a course of antibiotics, a biopsy may be done, where tissue from the mass is examined under a microscope. This is not usually done until other methods of diagnosis have been explored first.

How Is Granulomatous Mastitis Treated?

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There haven’t been many studies done on idiopathic granulomatous mastitis, so treatment recommendations vary and the best course of treatment is debatable. Typically a patient is treated with antibiotics as well as corticosteroids (which decreases inflammation in the body). Treatment is essentially used to help with discomfort and to speed up the patient’s recovery. If untreated, granulomatous mastitis usually resolves on its own in 9 to 12 months. If symptoms are persistent, regular steroid therapy and surgery to remove the lump may be recommended.

Having granulomatous mastitis does not increase your risk of breast cancer.

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