IDIOPATHIC GRANULOMATOUS MASTITIS

• Often patients present with features of mastitis (nonlactating) with pain, nipple retraction, lump in the breast.
• Some of them are treated with antituberculous treatment with FNAC, trucut or even biopsy findings of granuloma but they are nontuberculous.
• When tuberculosis, sarcoidosis, diabetes and Wegener's granulomatosis are excluded, the diagnosis of idiopathic granulomatous mastitis is made.

Characteristic histological features: - include multinucleated giant cells, epitheloid histiocytes-noncaseating

Possible aetiological factors are trauma, hyper prolactinaemia, local irritation.

Idiopathic granulomatous mastitis is a rare breast condition that may mimic bacterial abscesses and several other breast diseases.

A thorough evaluation must be performed in suscepted cases to exclude other causes, and heightened suspicion in diagnosing this often under recognized condition.

Idiopathic granulomatous mastitis is rare benign inflammatory breast entity characterized by lobulocentric granulomas. It has a persistent or recurrent disease course and affects parous premenopausal women with a history of lactation. It has also been associated with Hyperprolactinemia.

CAUSES: - The etiology of idiopathic granulomatous mastitis is still not clear. Its treatment remains controversial. The cause may be the: -

• Autoimmune process.
• Infection
• A chemical reaction associated with oral contraceptive pills.
• Even Lactation.

SYMPTOMS AND SIGNS: - The most common clinical sign is a palpable tender mass. However, the nonspecific manifestations are varied demographic features of this condition. There are other similar appearing and superimposed breast entities.

COMPLICATIONS: -

• Regional lymphadenopathy may be present upto 15percent of cases.
• Nipple discharge and skin retraction.
• Enlarged axillary lymph nodes.
• Suppuration with micro abscess and scattered granulomas.

TREATMENT: -

• Symptomatic treatment to decrease pain and fevers.

HOMOEOPATHIC MANAGEMENT OF IDIOPATHIC GRANULOMATOUS MASTITIS

When mastitis is concerned there are many effective medicines available in homoeopathy, but the selection depends upon the individuality of the patient, considering the mental and physical symptoms.

Belladonna: - Useful in the initial stage. Mastitis with throbbing pain, redness, and streaks radiate from the nipple. Breasts feel heavy, are hard, red and swollen. Pain worse on lying down. Inflammation after weaning.

Bellis perennis:- Mastitis. Breasts hot, painful and hard. Stony hard breasts. Sharp stitching pain in breast worse from motion and better from rest. Must support the breast with hands.

Croton tig:- Breast inflamed. Pain from Nipple to back when the child nurses. Breast hard and swollen. Nipples very sore to touch.

Hepar sulph:- When pus is formed. Very painful and sensitive to touch. Chilly.

Phytolacca decandra:- Mastitis, breasts feel heavy, stony, hard swollen or tender and of purple hue. Nipples sensitive, sore and fissured, when child nurses, pain goes from Nipple all over the body. Cracks and small ulcers around nipples.

Scrophularia nodosa:- Lumps and nodosities in the breasts. A specific remedy.