Plasmacytoid mastitis is a relatively rare non-bacterial inflammatory disease of the breast. Recurrent episodes of the disease are painful and can destroy a woman’s breasts to the point of destruction. Can only the affected breast be cut out? Recently, I have been seeing many patients with plasmacytoid mastitis. The lumps develop quickly, growing larger than a duck’s egg in 1-2 weeks, and in some cases, the skin becomes red and even breaks down and flows pus. The cause of plasmacytic mastitis is not very clear, and it is generally believed that it may be related to the functional state of the breast and endocrine disorders. It is more often seen in patients with congenital nipple deformity, sunken nipples, or who have had mastitis or a history of breast surgery or trauma that has destroyed the ducts of the breast. The accumulated secretions stimulate the local tissues and the body therefore secretes a large number of plasma cells, which overflow from the milk ducts, resulting in an inflammatory disease with a predominantly plasma cell infiltration. Although the disease is “inflammatory”, the majority of patients do not have fever, except when the disease is prolonged and accompanied by other bacterial infections. The following are the characteristics of plasmacytic mastitis: 1. Age of prevalence: The disease is most often seen in non-lactating women aged 30-50 years and has a slow or acute onset. 2. 2, clinical manifestations: the lesion begins with breast pain may be accompanied by a lump around the areola, the lump is hard or tough in texture. The skin color is red, skin temperature is high, and pressure pain is obvious. The nipples may have a pimple-like discharge with a foul taste. However, when the lesion is slightly distant from the nipple, there may also be no nipple discharge. As the disease progresses, local abscesses may form. The abscess usually communicates with the nipple and forms a fistula. The ipsilateral axillary lymph nodes may be enlarged in patients with long duration of disease. Some patients with plasmacytoid mastitis have overflow as the main symptom; some have lumps around the nipple as the main symptom; some have abscesses around the nipple as the main symptom; the abscesses break down on their own or are incised and drained, leaving fistulas that do not heal over time; more often, they are so bad that the breast becomes an indescribably ugly monster! How can I treat plasmacytosis mastitis? This condition cannot usually be cured by medication or injections. Because the cause is not a bacterial infection, it is actually an autoimmune disease. To put it bluntly, the organism attacks these acne-like substances in its own body as if they were the enemy. So, without getting rid of these substances that cause allergies, plasmacytoid mastitis will recur. Some patients end up with malignant breast cancer because of years of plasmacytic mastitis, it’s so not worth it! Chinese medicine has a lot of insights in treating this ailment, however, it still requires oral herbal medicine or herbal replacement on top of surgical removal. The course of the disease usually takes more than a few months, the scar is more obvious after healing, the appearance of the breast is worse, and there is still a fairly high risk of recurrence. Currently, Dr. Song Hui and his team have performed several cases of “subcutaneous glandular excision with simultaneous implantation of the nipple and areola”. In other words, the patient’s nipple and areola are completely preserved and the shape of the breast is symmetrical with the opposite side! While the diseased tissue is completely removed, the appearance of the breast is preserved, and patients no longer have to worry about the lack of breast shape. The picture below is from a 29-year-old patient I recently admitted. At her last follow-up appointment, she was so happy that her reconstructed breast was even more lifted than the opposite side!