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The hidden cause of granular mastitis: Why do certain drugs trigger this strange disease?
Granular mastitis, a systemic inflammation of the breast, is usually divided into idiopathic granular mastitis (IGM) and granular mastitis caused by a variety of other diseases. Idiopathic granular mastitis is a condition that cannot be attributed to other known causes that occurs between two and six years after pregnancy and is diagnosed mainly in women aged 17 to 42 years.
The symptoms of granular mastitis usually present as a hard lump in the unilateral breast, accompanied by nipple inversion, pain and inflammation of the surrounding skin.
Although cases of granular mastitis are relatively rare, the disease is often misdiagnosed as breast cancer. Therefore, accurate diagnosis is crucial. The clinical manifestations of the disease are often accompanied by varying degrees of systemic symptoms, such as fever, joint pain, and skin nodules. This makes the diagnosis process lengthy and complex, often requiring the exclusion of other possible causes.
Causes of granular mastitis
Although the specific cause of idiopathic granular mastitis is unknown, researchers speculate that it may be related to an immune system response. In particular, high prolactin levels may be an important factor in inducing the disease. In addition, hyperprolactinemia caused by drugs such as antipsychotics has also been considered as a potential cause.
“In cases of idiopathic granular mastitis, noncaseating granules formed by multinucleated macrophages and epithelioid histiocytes are commonly observed.”
When we look at specific cases, we find that some patients develop symptoms of granular mastitis after using drugs that induce hyperprolactinemia. These drugs increase the secretory activity of breast glands, which may promote the development of chronic inflammation.
Diagnosis and Treatment
The diagnosis of granular mastitis often requires a comprehensive examination to rule out other diseases with similar symptoms. Final confirmation requires biopsy to examine pathological changes in breast tissue. Current treatment options for the disease are immature, and some patients may improve during treatment, while others may require more radical surgery or steroid drugs for long-term control.
“In cases of granular mastitis treated with either surgery or the use of steroid therapy, the relatively high recurrence rate has attracted the attention of clinicians.”
There are still people who have reported relatively good results when using non-drug treatment options, such as the use of combination therapy with Medecin and steroids. In addition, prolactin-lowering agents are an option for patients with drug-induced hyperprolactinemia.
Future research directions for granular mastitis
Faced with the unique condition of granular mastitis, future research should focus on understanding which specific drugs may trigger such reactions and how to provide more effective prevention and treatment options for these causes. The management and early intervention of hyperprolactinemia should also be the focus of future research.
Although granular mastitis is a benign condition, the symptoms it causes can significantly affect the patient's quality of life. Amid growing research interest, how can the medical community unravel the mystery of granular mastitis?
