Objective To explore the procedure options in the treatment for acute plasma cell mastitis with minimal compromise to breast appearance. Methods The clinical data of 19 cases diagnosed as acute plasma cell mastitis from 2007 to 2010 were analyzed retrospectively. All the patients were adopted the same protocol as the combination of traditional Chinese medicine,abscess drainage at the proper moment,and the excision of focal mass after the acute inflammatory response diminish. Results The duration from taking traditional Chinese medicine to lumpectomy in all the patients were from 63 d to 97d,and the average time was 78d. Seven cases were treated with antibiotic before lumpectomy and 12 cases were treated with abscess drainage,and all the patients were cured satisfactorily. All the patients were followed up for 24-48 months with an average 36 months, there was no recurrence,and the shape of the treated breast remained consistent with the contralateral side,with the natural shape and smooth skin,and an undetectable thready mammary areola incision left. Conclusion The combination of traditional Chinese and Western medicine could treat acute plasma cell mastitis efficiently and with an advantage of minimal compromise to breast appearance.
目的 探讨乳腺导管扩张症的临床特点、诊断、鉴别诊断及治疗。方法 对我院1990年至1999年收治的30例乳腺导管扩张症患者,进行一般情况、治疗及预后的回顾性分析和总结。结果 本组病例平均发病年龄42岁,首发症状以乳腺肿块和乳头溢液多见,病变多位于乳晕周围,所有患者均行手术治疗。结论 乳腺导管扩张症为非感染性炎症,病史长、易反复,鉴别诊断有一定困难,均需外科治疗。
ObjectiveTo summarize the clinical manifestations and treatment of plasma cell mastitis. MethodsWe retrospectively analyzed the diagnosis and treatment of 53 patients with plasma cell mastitis admitted into the hospital between January 2008 and December 2014. ResultsTwelve patients with nipple discharge underwent mammary gland segment resection in which the complete discharging tube system and part of the normal gland were resected. In the 26 patients with inflammatory masses, 12 had acute inflammation with mass formation who were treated with abscess incision drainage and silver alginate wound dressing before second-stage lesion resection. Fourteen patients with only local swelling, tenderness and no abscess formation underwent lesion resection after the abscesses were reduced by combined traditional Chinese medicine (TCM) and western medical treatment. Seven patients with painless mass all had abscesses in the areola area, among whom 5 had complete inflammatory capsule and they underwent lumpectomy. Two patients had cheese-like tissue beside the abscess, and they underwent segmental resection. In the 8 patients with chronic fistula, one at the age of 51 was cured by simple mastectomy after recurrence, and the other 7 underwent lesion resection after combined TCM and western medical treatment. All the 53 patients were diagnosed to have plasma cell mastitis by surgical biopsy, and they were all cured with no recurrence 6 months after surgery. Conclusions Plasma cell mastitis is usually misdiagnosed because of its diversified clinical manifestations. For patients whose lesion is large and not confined, it's better for them to receive combined TCM and western medical treatment. Surgical time and approach should be chosen appropriately. Surgical lesion resection is the only method for complete treatment in patients with plasma cell mastitis.