Clinical characteristics and microbiota analysis of 44 patients with granulomatous mastitis

Abstract

IntroductionGranulomatous mastitis (GM) is a chronic inflammatory breast disease. In recent years, the role of Corynebacterium in GM onset has received more and more attention. This study aims to detect the dominant bacterium in GM patients and analyze the association between clinical characteristics and infectious factors.MethodsIn this study, 88 samples from 44 GM patients, six acute lactation mastitis (ALM) patients, and 25 non-inflammatory breast disease (NIB) patients were divided into a GM pus group, a GM tissue group, an ALM pus group, and a NIB tissue group; then, 16S ribosomal DNA sequencing was used to explore their microbiota. The clinical data of all 44 GM patients were also retrospectively collected and analyzed to determine their relationship with infection.ResultsThe median age of the 44 GM patients was 33 years, and 88.6% of patients had primary-onset cases, while 11.4% were recurrences; additionally, 89.5% of patients were postpartum and 10.5% were nulliparous. The serum prolactin level was abnormal in nine patients (24.3%). Samples from 15 GM patients (34.1%) had a Corynebacterium abundance of >1% (1.08–80.08%), with eight (53.3%) displaying an abundance of >10%. Corynebacterium was the only genus with significant differences between the GM pus group and the other three groups (p < 0.05). Corynebacterium kroppenstedtii was the predominant Corynebacterium species. Among clinical characteristics, a statistical difference in breast abscess formation was observed according to Corynebacterium abundance in Corynebacterium-positive and- negative patients (p < 0.05).DiscussionThis study explored the relationship between Corynebacterium infection and GM, compared the clinical characteristics between Corynebacterium-positive and- negative patients, and provided support for the role of Corynebacterium species-in particular, C. kroppenstedtii-in the pathogenesis of GM. The detection of Corynebacterium can predict GM onset, especially in patients with high prolactin levels or a history of recent lactation.

Pathological manifestations of granulomatous lobular mastitis

“…The pus samples are more diverse than their skin samples (63) and are more abundant than in tissue samples. In a study by Wen Chen et al, the samples from 34.1% GLM patients had a Corynebacterium abundance of >1% (1.08-80.8%), with 53.3% displaying an abundance of >10% (64). Pathogen discovery will help guide clinical treatment.…”

Construction of a Multi-Indicator Model for Abscess Prediction in Granulomatous Lobular Mastitis Using Inflammatory Indicators

“…In severe cases, it may be accompanied by systemic symptoms such as fever and erythema of the lower limbs. [2][3][4] The clinical stages of GLM include the self-limited stage, the congestive swelling stage, the abscess formation stage and the complex refractory stage. 5 Almost all patients will progress to the abscess formation stage if left untreated.…”