Granulomatous lobular mastitis treated by a combined internal and external treatment of traditional Chinese medicine: A case report

Figure 1 Bilateral edema of the lower limbs with erythematous nodules. A: Initial diagnosis on June 17, 2022, before medication; B: Second visit on June 23, 2022, medication for 1 week; C: Third visit on June 30, 2022, 2 weeks of medication.

Figure 2 Granulomatous mastitis of the left breast. A and B: Ultrasound images (outer lower quadrant of the left breast: 50 mm × 24 mm, below the left nipple: 46 mm × 22 mm); C and D: Magnetic resonance imaging images, manifesting non-mass enhancement lesions in multiple areas of the left breast, with irregular shape, "grid and burr" signals at the edges, surrounding skin edema, and skin fistula formation in the inner and lower quadrants; E and F: Pathological images (hematoxylin and eosin staining; original magnification, × 200), showing squamous epithelial hyperplasia, interstitial acute and chronic inflammatory cell infiltration, local abscess and granuloma formation, with vacuoles in the center, surrounded by layers of inflammatory cells, such as neutrophils and multinucleated giant cells.

Figure 3 The patient's left breast. A: On the day of surgery, multiple ulcers were seen, accompanied by a small volume of yellow-white pus overflow; B: On the 2^nd post-operative day, the two small sores are connected with a cotton thread, which can be pulled out during daily dressing changes, and after spreading the therapeutic powder, the cotton thread is dragged into the inside of the sore cavity, so that the powder is sent to the sore cavity; C: On the 12^th post-operative day, the wound cavity was fumigated and washed; D: On the 24^th post-operative day, a type of round wound measuring about 2 cm × 1 cm was observed on the medial side of the left areola.

Figure 4 Images of the patient's breasts on September 24. A: The surgical wound has been completely healed and the surgical scar is not obvious; B: The shape of the patient's both side of breasts is basically symmetrical after surgery. This combination internal and external traditional Chinese medicine treatment of granulomatous lobular mastitis has a protective effect on the patient's breast appearance.