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conferenceseries .com
6th World Congress on
October 16-18, 2017 | San Francisco, USA
Breast Cancer & Therapy
Volume 2, Issue 5 (Suppl) Breast Can Curr Res, an open access journal Breast Cancer Congress 2017
October 16-18, 2017
Idiopathic granulomatous mastitis mimicking inflammatory breast carcinoma: What are the odds?
Bilawal Ahmed, B. Zulfiqar, U. Appalaneni, A. Hassan, P. Boddu and A. Carey
University of Missouri-Columbia, USA
Background: While inflammatory breast cancer is rare, idiopathic granulo-matous mastitis is more uncommon. We hereby present
a very rare case of granulomatous mastitis which thought to be inflammatory breast cancer.
Case: A 27-year-old Hispanic woman presented with a breast lump, fever, joint pain, and a rash over her anterior shins. Since 1 one
month of presentation she had noticed a breast lump which was slowly increasing in size. She was a mother of 2 children and had
last breastfed 3 years ago. She denied any trauma to the breast or any nipple discharge. In the week prior to admission, the patient
also began to experience fever and joint pain, most severely in her left knee. During this time, she also developed multiple tender
lesions over her lower extremities. On physical examination, patient was noted to have a 7 5 cm indurated mass over the right upper
quadrant of her right breast, with overlying fluid and ecchymosis, no nipple discharge or retraction and no axillary lymphadenopathy.
The patient had multiple tender erythematous nodules measuring 1–2 cm in diameter over her anterior shins in addition to one
larger lesion measuring 5 cm on her right lateral thigh. The patient had mild effusion of the left knee with tenderness to palpation
of the popliteal fossa and significant pain with both passive and active range of motion of her left knee. On admission, she was
febrile, tachycardiac and distressed. Laboratory work revealed leukocytosis of 12.8 (87% neutrophils, 7% lymphocytes). Furthermore,
inflammatory and autoimmune work up showed elevated CRP 12.1 and ESR 77, a procalcitonin level <0.05. Investigations for HIV,
RPR, Histoplasma urine antigen, Group A Streptococcus, antinuclear antibody, rheumatoid factor, and anti CCP antibody were
negative. Quantiferon Gold testing was indeterminate. In regards to her left knee swelling, a lower venous duplex study showed no
evidence of DVT but did find a likely Baker’s cyst measuring 3–4 cm in the left popliteal fossa. Moreover, breast ultrasound and an
ultrasound guided core needle biopsy confirmed findings of granulomatous mastitis with some neutrophilic infiltrate. Patient had
been treated empirically with IV vancomycin until the diagnosis was confirmed. Following diagnosis, the patient was started on
corticosteroids after which she improved clinically and was discharged on 6 weeks of steroid taper.
Biography
Bilawal Ahmed MD is Hematology/Oncology fellow from University of Missouri-Columbia. His research interests include inflammatory breast cancer and axillary lymphade-
nopathy.
Bilawal Ahmed et al., Breast Can Curr Res 2017, 2:5 (Suppl)
DOI: 10.4172/2572-4118-C1-011