Lupus mastitis is a variant of lupus panniculitis which involves the female breast.


Clinical features of lupus mastitis:

(1) usually (but not always) the patient has a history of systemic lupus erythematosus (SLE)

(2) development of a breast mass that may be painful and which may show erythema and/or ulceration of the overlying skin


Imaging studies show:

(1) increased breast density due to progressive fibrosis which eventually leads to a decrease in breast size

(2) dystrophic calcifications which can progress to large, confluent sheets of calcifications


Histologic features:

(1) chronic inflammation with multifocal fat necrosis

(2) lymphocytic perivasculitis or necrotizing vasculitis

(3) dystrophic calcifications in areas of fat necrosis

(4) dense fibrosis


Differential diagnosis:

(1) breast carcinoma, especially inflammatory carcinoma

(2) lymphoma

(3) blunt trauma

(4) idiopathic granulomatous mastitis


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