Inflammatory Breast Disease

Inflammatory Breast Disease

·        Acute Mastitis and breast abscess:

o  Usually occurs in early lactation

o  Usually staph aureus (abscess), less often strep (cellulitis)

·        Fat Necrosis:

o  A solid mass caused by injury (eg seat belt injury) 

o  Necrotic fat cells surrounded by an inflammatory infiltrate, with later calcification and scarring. Can mimic carcinoma

·        Duct ectasia

o  Uncommon cause of a breast mass.  Usually older woman, tender and nipple retraction 

o   Pathogenesis: Dilation of larger ducts with secretions ® loss of epithelium ® ulceration ® blood or serous discharge ® infection ® periductal mastitis (abscess + fibrosis) ® nipple retraction 

o  Histology: Chronic inflammation and fibrosis around ducts loaded with lipid and macrophage rich material

o  Cause unknown.  Correlated with smoking 

o  ® Preductal mastitis: periareolar inflammation, abscess formation, unilateral, single duct, etc

·        Plasma cell mastitis: Rare cause of a breast mass. Probably the same as duct ectasia but with ­plasma cells

·        A tumour can block lymphatics causing inflammation Þ cancer is always a differential