Akbari Rad Mina, Sheybani Fereshte, Gharib Masoumeh, Aghel Elahe, Emadzadeh Maryam, Mottaghi Mahdieh
Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Int J Surg Case Rep. 2025 Aug;133:111628. doi: 10.1016/j.ijscr.2025.111628. Epub 2025 Jul 9.
This study aims to provide insights into the characteristics of patients who experience both conditions of lobular granulomatous mastitis (LGM) and breast carcinoma. This patient was the only case among our 246 consecutive patients with LGM who experienced both LGM and malignancy.
A 46-year-old Persian woman was diagnosed with left-sided LGM via core-needle biopsy, which resolved following two years of prednisone and subsequent methotrexate therapy. Three months after remission, she developed stiffness in the contralateral breast, and biopsy revealed grade 3 invasive ductal carcinoma that was estrogen receptor (ER)-positive, progesterone receptor (PR)-negative, and HER2 (1+).
The prevalence of coexisting LGM and breast cancer among LGM cases was 0.41 %. In our review of 20 patients, LGM occurred prior to breast cancer in nine cases (45 %), concurrently in nine cases (45 %), and subsequent to breast cancer in two cases (10 %). Among the 20 reviewed cases, invasive ductal carcinoma (IDC) was the most frequently identified malignancy, observed in 15 patients (75 %), while ductal carcinoma in situ (DCIS) was reported in five cases (25 %). Hormone receptor positivity (estrogen and/or progesterone receptor) was noted in 11 patients (55 %), and HER2 overexpression was present in seven cases (35 %).
New breast findings in individuals previously diagnosed with LGM should not be readily interpreted as a disease recurrence. To minimize the risk of misdiagnosis, bilateral assessment-including bilateral mammography or biopsy-is recommended, particularly in older patients, postmenopausal women, those with recurrent episodes, or when the contralateral breast is involved.
本研究旨在深入了解同时患有小叶性肉芽肿性乳腺炎（LGM）和乳腺癌的患者特征。该患者是我们连续收治的246例LGM患者中唯一一例同时患有LGM和恶性肿瘤的病例。
一名46岁的波斯女性通过粗针活检被诊断为左侧LGM，经过两年的泼尼松及后续甲氨蝶呤治疗后病情缓解。缓解三个月后，她对侧乳房出现硬结，活检显示为3级浸润性导管癌，雌激素受体（ER）阳性、孕激素受体（PR）阴性、HER2（1+）。
LGM病例中LGM与乳腺癌并存的发生率为0.41%。在我们对20例患者的回顾中，LGM在乳腺癌之前发生的有9例（45%），同时发生的有9例（45%），在乳腺癌之后发生的有2例（10%）。在这20例回顾病例中，浸润性导管癌（IDC）是最常见的恶性肿瘤，15例患者（75%）中观察到，而导管原位癌（DCIS）有5例报告（25%）。11例患者（55%）出现激素受体阳性（雌激素和/或孕激素受体），7例患者（35%）存在HER2过表达。
先前诊断为LGM的个体出现新的乳腺病变时，不应轻易被解释为疾病复发。为了将误诊风险降至最低，建议进行双侧评估，包括双侧乳腺钼靶检查或活检，特别是在老年患者、绝经后女性、有复发史的患者或对侧乳房受累时。
