The incidence of plasmacytoid mastitis has increased significantly in recent years. The clinical features of plasmacytoid mastitis include lumps in the breast or areola area with redness and swelling, repeated breakage, pus flow, non-healing incisions after surgery, easy recurrence and misdiagnosis and misdiagnosis, so many breast surgeons call it the most difficult breast disease. Cheng Xufeng, Department of Breast Surgery, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine
Western medical treatment is currently focused on surgery and the application of antibiotics, hormones, anti-TB drugs, but surgery is prone to recurrence and post-operative incision healing difficulties, patients due to repeated surgery will lead to serious deformation of the affected side of the breast or even the risk of losing the breast; the current clinical application of antibiotics has been confirmed to be ineffective and can only lead to serious drug resistance; hormone application may be effective for the time being, but once discontinued the disease is prone to recurrence. The application of hormones may be effective temporarily, but once discontinued, the disease is prone to recurrence, and long-term application of hormones is unacceptable to patients because of the huge side effects. Therefore, Western medicine alone is not the best medical option.
The first is the clinical experience of the receiving physician, because the overall incidence of plasmacytoid mastitis is not high, and many doctors have little experience, so they do not have a clear understanding of the pathogenesis, evidence, medication and pattern of evolution of the disease, and often fail to achieve good treatment results; the second is that the appropriate surgical treatment is necessary at the right time, otherwise it is easy to relapse with too long treatment period.
In the past two years, according to a large number of clinical practice, our hospital has adopted a combination of Chinese and Western medicine treatment methods, and the efficacy has made significant progress and breakthrough. If the redness and swelling are obvious, we apply a special preparation of Jinhuang Ruyi cream; if abscesses appear during the treatment, we perform puncture and drainage without blindly performing incision and debridement or breast quadrant excision. If the entire condition is controlled and the inflammatory lesion is very limited and completely reduced, then the tiny fistula or inflammatory lesion is excised completely and minimally invasively under color ultrasound localization, and nipple orthopedic and intra-glandular plastic surgery is performed at the same time. At this point, the surgery will have no effect on the shape of the breast because the lesions are so small.
A significant number of patients have also been cured without surgery through a combination of TCM treatments, and we are in the process of following up on the long-term outcome and believe that encouraging data will emerge.
Based on our case summaries and comparisons, our hospital is in the leading position in the treatment of plasmacytoid mastitis in Henan Province and in China in terms of hospitalization days, medical costs, recurrence rate, and degree of breast damage.
In addition, the treatment prescriptions of Chinese medicine are not static, but are constantly adjusted and changed according to different stages of the disease.
During the treatment phase, seafood, spicy and mutton need to be avoided for 3 months because of the possible presence of hyperallergic reactions. It is recommended to hold off pregnancy for 1 year.