The pathogenesis of plasma cell mastitis is generally considered to be a non-bacterial septic breast disease caused by abnormal development of the large ducts of the breast, resulting in excessive lipid secretion in the ducts, which cannot be excreted or absorbed in a timely manner. Most patients have congenital nipple indentation or linear partial indentation. The onset of the disease is unilateral in the breast, but in a few patients, the onset of the disease is bilateral and chronic, with a variety of manifestations and a duration of several months or years. 1, nipple overflow: nipple overflow is one of the early manifestations of the disease. Most of them are intermittent, spontaneous, and can last for a long time. The nature of the overflow is mostly plasma, but can also be milk-like, purulent or bloody. The amount may be more or less. The milk delivery hole has more pimple-like or oil-like secretion, with a foul smell. 2, breast lumps: the most common. They often start suddenly and have a rapid onset. The patient feels localized pain and discomfort in the breast, with stabbing or dull pain, and a lump is found. The lumps are mostly located in the areola area or extend to a certain quadrant. The size of the lump varies, mostly less than 3 cm, and may reach more than 10 cm. The mass is irregular in shape, hard and tough, with a nodular surface, poorly defined borders, no pericardium, and often adherent to the skin, but without chest wall fixation and can be pushed. If the inflammation is not controlled, an abscess may be formed; some breast skin is edematous and orange peel-like; some may be accompanied by swollen and painful axillary lymph nodes on the affected side. There is usually no generalized fever. Some patients also have been complaining of breast lumps that last for several years, always without obvious redness or swelling. 3.Mammary fistula: After the abscess is self-collapsed or incised, it often repeatedly flows with pus and is interspersed with powder-like material, often forming a fistula with nipple, which does not heal for a long time. 4, ultrasound and mammography without specific changes: not very helpful for diagnosis. In other words, pulpy breast mainly depends on clinical diagnosis, and auxiliary examination can only help to exclude breast cancer. 5.Seriously disfigured: It is common to see multiple incisions and ruptures, a lot of sores and scars, distorted nipples, breast deformation, pigmentation, and serious breast disfigurement. 6, easy to misdiagnose and mismanage. Granulomatous mastitis Granulomatous mastitis is a type of chronic inflammation of the breast with granulomas as the main pathological feature, including a number of clinical conditions, one of which is more common, the cause is unknown, granulomatous inflammation centered on the lobules of the breast, so it is called granulomatous lobular mastitis (GLM), first reported by Kessler in 1972, the name of the disease is recognized by most scholars. Previously, it was called idiopathic granulomatous mastitis, mammary granulomatosis or granulomatous lobulitis, a granulomatous lesion of the breast with non-caseous necrosis confined to the lobules, in which no pathogen can be identified, probably an autoimmune disease, the incidence of which was previously low, so that not many clinical and pathologists have observed and studied it Etiology: 1. Autoimmune diseases: local immune phenomena caused by milk and local hypersensitivity reactions. Non-bacterial infections, associated with the application of oral contraceptives. May also be related to infection, trauma, chemical irritation causing inflammation, destruction of ductal epithelium, entry of luminal contents into the interlobular stroma, causing granulomatous reaction and further destruction of lobular structures. Prevalent in women of childbearing age, married with childbirth. 2. It may be due to the milk, secretions and keratinized epithelium in the ducts escaping retrogradely into the lobular mesenchyme, causing a local inflammatory reaction and hypersensitivity reaction, leading to the formation of granuloma tissue. 3. Microabscesses, epithelioid macrophages and foreign body granuloma formation are seen in the lesions. It is believed that the disease occurs as a result of local infection, trauma and chemical substance-induced inflammation, which causes granulomatous inflammation due to inflammatory injury resulting in destruction of the duct epithelium and entry of ductal luminal contents into the lobular mesenchyme. Clinical manifestations The main manifestations are: breast lumps, painful, hard, irregular in shape and poorly defined from normal tissues, and also ipsilateral axillary lymph node enlargement. The onset of the disease is sudden or the lump suddenly increases in size, and a few days later the skin becomes red and forms a small abscess, which breaks down with little pus and does not heal for a long time, and the redness and swelling breaks down one after another. The initial lump phase is similar to breast cancer, which may lead to misdiagnosis and mistreatment. Some people rashly perform radical mastectomy for breast cancer and should wait patiently for the results of paraffin section on the table. The disease must also be differentiated from breast tuberculosis and fat necrosis of the breast.