Plasmacytic mastitis results from the accumulation and overflow of fatty material in the breast ducts, causing chemical irritation and immune response around the ducts, leading to massive plasma cell infiltration. Plasmacytoid mastitis, also known as breast duct dilatation, acantholytic mastitis, occlusive mastitis, etc., which is called breast leakage or nipple fistula in Chinese medicine, is a non-bacterial inflammatory reactive disease. Zhang Mingshuai, a specialist in breast surgery of Xinjiang Cancer Hospital, analyzes the causes of plasma cell mastitis. I. It is related to nipple dysplasia, like nipple inversion and nipple splitting. The congenital malformation and depression of the nipple must also cause distortion and deformation of the breast ducts. Second, a history of mastitis, the diseased area of the breast ducts due to inflammatory hyperplasia, resulting in narrow occlusion of the lumen of the breast ducts. The inflammation is caused by a large number of lymphocytes and plasma cells reacting and forming small inflammatory masses. Third, middle-aged and elderly women due to ovarian hypofunction. This leads to degenerative changes and relaxation of the breast ducts and accumulation of secretions that cause disease. Health tips: Patients with plasma cell mastitis often have edematous, orange peel-like nipples, often with powdered slag-like material secretion, with a foul odor. The development of the disease will form abscesses, fistulas, resulting in recurring wounds and scarring, making the nipples sunken into concave. This is a great pain and injury to the patient, and the condition should be examined and treated in time. 1.B ultrasound: This is a preliminary screening test for breast lumps, and can be used to determine the nature and location of the lump. 2.Infrared scan: It is often used as the initial screening test for breast diseases. It is especially suitable for screening women during pregnancy and lactation. 3.Mammography: It has high imaging sensitivity for benign breast lumps, calcifications, nodal points and cancerous lesions, and can detect cancer in situ 10 years in advance. There are two main types (a) Fistula type: chronic recurrent parametrial abscess or fistula, also called “ductitis”. It is usually seen in unmarried girls or young women, and is associated with 90% of nipple developmental abnormalities, such as split nipples, nipple inversion or invagination, or small or flat nipples. Because of nipple dysplasia, nipple entropion inevitably causes distortion of the ducts and poor drainage of the contents. The accumulation and degeneration of fatty substances in the large ducts stimulate the duct walls and cause inflammatory reactions around the ducts. Because lipid-like substances are produced autologously, the induced inflammation is a metaplastic, cellular immune response. It is not a purulent inflammation caused by bacterial infection as in acute mastitis during lactation. Therefore, the inflammatory reaction is slow, with mild initial symptoms, no fever, and no severe pain. It is not until a part of the areola next to the breast becomes red, swollen or a small abscess that you seek medical attention. Unfortunately, non-breast specialists do not recognize this disease and think that it is better to cut and drain it like a small abscess on other parts of the body. In fact, the fistula is already formed, and the inner opening of the fistula is in the milk duct under the nipple or in the large duct near the milk duct, where the original columnar epithelial cells of the large duct become squamous epithelium (the same as the milk duct and nipple skin), forming an inflammatory necrotic lesion. If the lesion at the internal opening and the entire fistula are not removed, the external opening will not heal, and incision and drainage can only solve the abscess problem and cannot completely cure the disease. (b) Mass: A chronic inflammatory mass that may have multiple breakdowns. It is mostly seen in middle-aged women and is mostly associated with inversion or splitting of the nipple, but there are also those with normal nipples. The onset may be associated with ductal dilatation. The mass is distant from the nipple and adheres to the skin, much like breast cancer. The masses show chronic inflammatory changes, are tough, poorly defined, slightly painful, and can increase in size suddenly, or sometimes large, sometimes small. The erythema ruptures and forms multiple complex fistulas or sinus tracts, and the rupture is always connected to the lesion behind the nipple, so local incision to clear the sore is impossible to heal. The biggest problem in the diagnosis of this mass type of plasma breast is how to differentiate it from breast cancer, and there have been reports of mistaken radical breast cancer surgery. If necessary, cytology can be done by puncture. If the diagnosis of plasma breast is confirmed and the inflammatory mass is large, treat it with herbal medicine to make the mass smaller. Generally, it needs to take medicine for more than one month to strive for the best time for surgery, to completely remove the lesion, to preserve the maximum normal breast tissue, to keep the breast shape, and to do nipple inversion plastic surgery. According to the pathological changes and the course of the disease, the clinical manifestations can be divided into 3 stages. 1. Acute stage Early symptoms are not obvious, there may be spontaneous or interstitial nipple overflow, only when squeezed there is discharge overflow, the overflow is brownish yellow or bloody, purulent discharge, this symptom can last for years. With the development of the disease, the decomposition of lipid secretions in the milk ducts, irritation, erosion of the duct wall and exudation into the extraductal mammary interstitium after causing an acute inflammatory reaction. The skin within the areola is red, swollen, warm and painful to the touch. Swollen lymph nodes may be palpable in the axillae with pressure pain. The whole body may have chills and high fever. This acute inflammatory-like symptoms will soon subside. 2. Subacute phase The acute inflammation has subsided and reactive fibrous tissue hyperplasia occurs on the basis of the original inflammatory changes. A lump with mild pain and pressure is formed in the areola area. The edges of the mass are indistinct, resembling a breast abscess, and the size of the mass varies. Pus can often be extracted by puncturing the mass. Sometimes the swelling naturally ulcerates and forms an abscess fistula. After the abscess is broken or incised, it does not heal for a long time, or a new small abscess is formed again after healing, so that the inflammation continues to develop. 3. Chronic phase When the disease is repeated, one or more hard nodules with unclear boundaries may appear, mostly located within the areola, which are firm in texture and adhere to the surrounding tissues, and if they adhere to the skin, the local skin shows orange peel-like changes, the nipple retracts, and in severe cases, the breast is deformed. Plasma or hemorrhagic overflow may be seen. Lymph nodes in the axilla can be located. It is sometimes difficult to distinguish from breast cancer clinically. The duration of the disease varies from a few months to several years or longer. The above clinical manifestations do not occur in all patients according to their progression, i.e., the first symptom may not necessarily be nipple discharge or acute inflammatory manifestations, but may be a subareolar mass first, and in the chronic stage, a long-lasting parareolar fistula may develop.