Lupus: The Great Pretender, Breast Manifestations of SLE

Herrmann, Stephen

doi:10.15436/2377-0902.15.023

Cited by 2 publications

(4 citation statements)

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“…Features of lupus mastitis include masses in the breast, axillary lymphadenopathy, fat necrosis, fibrosis, and calcifications. The mean age of presentation is 37 years old, and predominantly women are affected, fitting the demographic profile of our patient [4]. Pathology pathognomonic for lupus mastitis includes lymphocytic infiltration, occasional germinal centers, and marked hyaline fat necrosis with sclerosis.…”

Section: Discussionmentioning

confidence: 52%

“…When SLE affects the breasts, this is known as lupus mastitis [4]. Lupus mastitis, typically but not always, presents as a single tender mass on clinical exam [4], and may show similar appearing calcifications on mammography as our patient [5]. Our patient did not present with breast tenderness, perhaps because it was relatively early in the disease process.…”

Section: Discussionmentioning

confidence: 72%

“…A subset of SLE, lupus panniculitis, results in inflammation of the subcutaneous adipose tissues. When SLE affects the breasts, this is known as lupus mastitis [4]. Lupus mastitis, typically but not always, presents as a single tender mass on clinical exam [4], and may show similar appearing calcifications on mammography as our patient [5].…”

Section: Discussionmentioning

confidence: 99%

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Breast involvement in mixed connective tissue disease

Varma

Szilágyi

Harshan

2019

Radiology Case Reports

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To date, mammographic involvement in mixed connective tissue disease has not been described in the literature to the authors’ knowledge. In addition, only 2 case reports have described panniculitis in mixed connective tissue disease. We present a patient with mixed connective tissue disease with coarse sheet-like calcifications on mammography bilaterally, which increased over time corresponding to rise in levels of anti-dsDNA. Biopsy showed fat necrosis with calcifications, chronic inflammation and fibrosis, vasculitis, as well as CD3, CD4, and CD8+ T cells and CD20+ B cells. These findings are similar histologically and mammographically to “lupus mastitis.”

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 72%

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Breast involvement in mixed connective tissue disease

Varma

Szilágyi

Harshan

2019

Radiology Case Reports

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“…Consequently, tissue sampling is required, usually by core biopsy. Granulomatous mastitis and lymphoma also constitute differential diagnosis of lupus mastitis [2,4,11,12]. Even though previous core biopsies didn't show cellular atypia, the patient had skin alterations such as erythema and edema, and in some inflammatory breast cancers atypia is not found on core biopsies.…”

Section: Discussionmentioning

confidence: 96%

Lupus mastitis: Suspicious breast lesion as a rare presentation of lupus

et al. 2023

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Introduction: Lupus mastitis is a rare disease. Rarely it can present in a patient without the diagnosis of lupus, being its first and even only manifestation. This makes the diagnosis even more challenging. The authors present a case that shows the difficult clinical pathway from diagnosis to treatment of an infrequent and poorly known disease. Case Report: A 42-year-old female was referred to our breast surgery outpatient clinic for a suspicious lesion in her right breast with a 10-month evolution. The patient had already been submitted to a series of imaging procedures and tissue biopsies. She did not have history of any autoimmune diseases. The patient was evaluated by different specialties and the diagnosis of lupus mastitis posed a challenge for all physicians involved. Since both clinicians and patient were concerned with malignancy, an excisional biopsy was performed. Lupus mastitis was the definitive diagnosis. The postoperative healing was challenging. The question whether excisional biopsy should or not be performed, as well as surgical procedures in general, was brought up. The risk and fear of malignancy were weighted against the gain of the procedure. Conclusion: Lupus mastitis is a rare and likely overlooked disease. It should be taken into consideration as a differential diagnosis for suspicious breast lesions. Need for surgery, being it excisional biopsy or lumpectomy, should be carefully weighted. This decision should be based on the risk of malignancy and efficacy of medical treatment.

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Lupus: The Great Pretender, Breast Manifestations of SLE

Cited by 2 publications

References 4 publications

Breast involvement in mixed connective tissue disease

Breast involvement in mixed connective tissue disease

Lupus mastitis: Suspicious breast lesion as a rare presentation of lupus

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