A self resolving case to add to all those rare (!) ones

[flogw]

I feel a little bit of a fraud posting to this forum as actually I'm one of the "self resolving" cases and am so glad I didn't have all the horrendous symptoms......

I had had my first and only child at 40, and lost my mother to breast cancer 14 months after diagnois when my daughter was 3 months old.

I had problems breast feeding my daughter, but solely expressed for her (no formula) until she was 1 year old. I had quite a few incidents of ordinary mastitis - as soon as I felt the tingling and heat, I'd be off for my antibiotics which cleared it up pretty much instantly

When my daughter was about 3, I rolled over in bed one morning, and felt a tender lump. It was huge. Got referred by my GP to my local hospital breat cancer unit, which happens to be Addenbrookes (the Cambridge teaching hospital) and had the usual tests. The radiologist (a lovely man) told me that it didn't look good, but there was a slim chance that it wasn't cancer. I was pretty worried because of the size and rapid onset - I'd done my research when helping my mum.

The biopsy came back with a diagnosis of granulomatous mastitis. The radiologist apologised for giving me such a scare but he'd given me an accurate assessment, and I was happy to be that "slim chance" and not to be thinking of chemo cycles/how my little girl and husband would manage without me.

I did some research to find out more about the condition but there was very little out there as you all know.  Addenbrookes checked to see that it wasn't bacterial etc, and suggested that we should wait to see if it resolved itself.  I must admit to having been a bit surprised, since all the references that I'd found were about surgery, steroids or methotrexate treatments!  Since my symptons were just a bit of discomfort from the tender lump, I was happy to do just that. I had several folllow up appointments and the swelling and the discomfort disappeared, and I was discharged, with a "free pass" to go back directly to the consultant should I have any further problems

I still have a hard lump in my breast - it occasionally feels a bit sore but goes away again. It does make the breast self exam a bit more tricky! I do wonder if I should take it more seriously, as I have read some research saying that GM appears to increase your risk of breast cancer.

As I've been reading through some other posts, I think I should say that also have some other auto-immune type problems - I have a non-specific inflammatory arthritis  which was diagnosed about a year before the granulomatous mastitis - for which my consultant ironically wanted to put me on methotrexate, which I decided against. And just recently I had my first asthma attack in over 25 years (!)

So I hope that I keep self-resoloved, and that everyone else affected by this gets a quick path to being well too - good luck!

[flogw]

Thanks for the reference JoJo - with those odds on a small sample size I'm more than happy to wait and see for the time being given my very mild symptons. Having been on some fairly hefty steroids for my asthma recently I'm not that keen on doing that again unless I need to - although I must say that the house became remarkably tidy when I was on the higher doses!

I'd also like to say thanks for setting up the forum - it's good to know that there are other people out there with the same condition.

There seems to be much more info out there on the net than there was when I was looking when diagnosed a few years ago  (although some of it doesn't exactly give a complete picture!) -  but it's also very good to hear some real stories about what has (and hasn't!) worked for us (which is mostly why I posted my own story)

[JoJo45]

Hi Flogw:

I think this is great!  Really happy for you and hopefully a few of our newer members will have the same experience.  Thanks for posting.

I know that 'expectant management or observation' - (not really doing anything and seeing what happens) is something that many caregivers advise, dependent of course on symptoms and biopsy results...unfortunately not an option for some, but really is great that some have the disease, but such mild symptoms and a good outcome without intravention.

Cheers to you :)

I pulled this:

Idiopathic Granulomatous Mastitis: In Search of a Therapeutic Paradigm
Authors: Wilson, Jason P.1; Massoll, Nicole2; Marshall, Julia3; Foss, Robin M.2; Copeland, Edward M.1; Grobmyer, Stephen R.1

Source: The American Surgeon, Volume 73, Number 8, August 2007 , pp. 798-802(5)

Publisher: Southeastern Surgical Congress

Abstract:

Idiopathic granulomatous mastitis, also known as idiopathic granulomatous lobular mastitis, is a benign breast lesion that represents both a diagnostic and therapeutic dilemma. We report two cases of granulomatous mastitis recently evaluated and managed at our institution. To better understand this rare disease, we analyzed treatment outcomes in reported cases of granulomatous mastitis. One hundred sixteen cases were subsequently analyzed. Primary management strategies included observation (n = 9), steroids (n = 29), partial mastectomy (n = 75), and mastectomy (n = 3). Success rates with each treatment were observation, 56 per cent; steroids, 42 per cent; partial mastectomy, 79 per cent; and mastectomy, 100 per cent. Based on this analysis, we propose a clinically useful algorithm for both workup and management of these challenging cases.
Document Type: Research article

Affiliations: 1: From theDepartment of Surgery, Division of Surgical Oncology and the Departments of 2: Pathology and 3: Radiology, University of Florida, Gainesville, Florida