Pathogens in patients with granulomatous lobular mastitis

Abstract

Objective: Granulomatous lobular mastitis (GLM) is a rare inflammatory disease of the breast that clinically mimics breast cancer. However, its etiology is not completely defined. The purpose of this study was to systematically study the bacteriology of GLM using advanced detection technology. Methods: Paraffin-embedded tissue from patients with GLM was collected. DNA was extracted from the samples and analyzed using next-generation sequencing (NGS) technology, and the data were processed using bioinformatics analyses. Results: A total of 40 patients were recruited into the study. A bioinformatics analysis revealed that a total of 17 genera or 19 species of pathogens were present in 39 of the GLM patients (97.5%). These included bacteria, fungi, and Mycobacterium tuberculosis complex group. Bacteria were found in 39 of the patient cases, while fungi were present in five. Only one case tested positive for M. tuberculosis complex. In addition, a single genus of pathogen was found in nine patients (23.1%), whereas 30 patients (76.9%) tested positive for multiple pathogens. Conclusions: This study profiled the microbiota of patients with GLM using NGS technology, which provides more useful information for establishing patient treatment plans.

Cystic Neutrophilic Granulomatous Mastitis: A Clinicopathological Study With 16s rRNA Sequencing for the Detection of Corynebacteria in Formalin-Fixed Paraffin-Embedded Tissue

“…Wang et al 41 identified C bovis and S warneri by 16s rRNA sequencing in a case with features of CNGM that showed Gram-positive cocci on Gram stain. Our study also had some cases that grew organisms like S aureus , coagulase negative staphylococci , and Escherichia coli on routine culture, as did Taylor et al 1 Wang et al 50 identified multiple pathogens including bacteria and fungi using next-generation sequencing on DNA extracted from FFPE of patients with granulomatous mastitis, and C kroppenstedtii in 35% of the patients. Similarly, Yu et al 49 found multiple bacteria using 16s rDNA metagenomic sequencing in the pus of patients with granulomatous mastitis.…”

Cystic neutrophilic granulomatous mastitis: an update

“…Other authors have described or presented images of histological features consistent with the CNGM pattern without appreciating the association with corynebacteria or using special stains (Gram) for the identification of GPB. Many of these cases are consequently diagnosed as IGM or chronic granulomatous mastitis 17–21…”

“…Special stains and microbial cultures should be performed in all cases of suspected granulomatous mastitis. Bacterial infections are the most prevalent and can be polymicrobial,54 although one study identified Pseudomonas as the most common genus 21. A high degree of suspicion should be maintained for tuberculosis (TB) mastitis, particularly in TB-endemic areas.…”

Novel Paradigm for Treating Idiopathic Granulomatous Mastitis

“…Nipple retraction, sinus formation, peau d'orange-like changes and axillary adenopathy are also common accompanying symptoms [3]. Until recently, the etiology of IGM was unclear, and it was generally regarded as a kind of inflammatory disease that may be related to autoimmune disorders, trauma, hyperprolactinemia and Corynebacterium infection [4,5].…”