Idiopathic Granulomatous Mastitis (IGM) is a benign chronic inflammatory breast condition that mimics two common breast disorders: breast carcinoma and breast abscess. It can form breast masses, fistulae, and fluid collections, resulting in breast disfigurement with retraction and nipple areolar complex (NAC) inversion. IGM most often presents in women of childbearing age within a few years of pregnancy, and can significantly impact lactation. Despite the prevalence of this disease, no current literature describes an approach to managing IGM during breastfeeding. A 28-year-old G3P2 patient of Native American origin presented to her obstetrician at 7 months pregnant with worsening left breast swelling and redness. She underwent a mammogram, ultrasound and core needle biopsy that confirmed the diagnosis of Idiopathic Granulomatous Mastitis. During the postpartum period, she underwent intralesional triamcinolone injections of her left breast. Due to the contraindication of breastfeeding after local steroid injection, the patient stopped breastfeeding from the affected breast and continued breastfeeding unilaterally. Idiopathic Granulomatous Mastitis is a challenging chronic inflammatory breast disease that affects women primarily in the reproductive years, with a higher incidence in patients of Hispanic, Native American, Middle Eastern, and African descent. Treatment of IGM during pregnancy and lactation has thus far not been addressed. We review the literature on the treatment of IGM in the non-lactating population, and propose considerations for treating breastfeeding women affected by this disease. Traditional treatment has included systemic immunosuppression and surgery, but newer literature demonstrates that intralesional injection of steroid can provide significant symptomatic relief to patients. A diagnosis of IGM does not preclude breastfeeding, though patients may experience challenges with milk production and latch on the affected breast. Individualized care should be provided, with considerations given to the following: side effects of systemic steroids, the need to wean a breast being treated with intralesional steroids, and augmentation of milk production on the unaffected breast to promote continued breastfeeding.

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哺乳期特发性肉芽肿性乳腺炎的治疗：病例报告及文献复习

特发性肉芽肿性乳腺炎 (IGM) 是一种良性的慢性炎症性乳腺疾病，类似于两种常见的乳腺疾病：乳腺癌和乳腺脓肿。它可以形成乳房肿块、瘘管和积液，导致乳房外翻和乳头乳晕复合体 (NAC) 倒置。IGM 最常见于怀孕几年内的育龄妇女，并且会显着影响泌乳。尽管这种疾病很流行，但目前没有文献描述在母乳喂养期间管理 IGM 的方法。一名 28 岁的美洲原住民 G3P2 患者在怀孕 7 个月时就诊于她的产科医生，左侧乳房肿胀和发红恶化。她接受了乳房 X 光检查、超声波和空心针活检，证实了特发性肉芽肿性乳腺炎的诊断。在产后期间，她接受了左乳房病灶内曲安奈德注射。由于局部注射类固醇后有母乳喂养的禁忌症，患者停止从受影响的乳房进行母乳喂养，并继续单侧母乳喂养。特发性肉芽肿性乳腺炎是一种具有挑战性的慢性炎症性乳腺疾病，主要影响育龄期女性，在西班牙裔、美洲原住民、中东和非洲裔患者中发病率更高。妊娠和哺乳期 IGM 的治疗迄今尚未得到解决。我们回顾了有关非哺乳期人群 IGM 治疗的文献，并提出了治疗受该疾病影响的哺乳期妇女的注意事项。传统治疗包括全身免疫抑制和手术，但较新的文献表明，病灶内注射类固醇可以显着缓解患者的症状。IGM 的诊断并不排除母乳喂养，但患者可能会遇到产奶困难并含住受影响的乳房。应提供个体化护理，并考虑以下因素：全身性类固醇的副作用，需要断奶接受病灶内类固醇治疗，以及增加未受影响乳房的产奶量以促进继续母乳喂养。