Has anyone had any experience with Lobular Granulomatous Mastitis? Mom 
breastfed twins, one for 12 months, the other for 28 months. Two months 
before the second twin weaned, she developed a tender area in one 
breast, that was diagnosed by fine needle biopsy as mild inflammation, 
which spontaneously resolved. 6 months later (4 months after weaning), 
the inflammation recurred and caused the breast to grow one cup size in 
2-3 weeks. Mom was given levaquin (500 mg per day for 30 days), and an 
ultrasound was done, which showed a large mass in the breast. The pain 
seemed to be reduced somewhat on the levaquin, but the mass continued to 
enlarge. An excisional biopsy was performed, and a walnut sized lump 
removed, which was diagnosed as lobular granulomatous mastitis. Mom was 
continued on the levaquin for 7 additional days to prevent 
post-operative infection. Pathology showed chronic inflammation and a 
granulomatous reaction in a lobular pattern. Now (a month after surgery) 
the incision will not heal and there is a raised red area on the breast, 
but cultures (for gram positive and negative bacteria, and 
mycobacterium) are all negative. Mom is also being cultured for 
tuberculosis, which can cause granulomatous mastitis.

The next step is a course of steroids, prednisolone has been used 
successfully according to my Medline search on the condition.

My client would like to know if anyone else has any experience with this 
rare condition, especially the recurrent variety which this seems to be.

Thank you in advance.
Catherine Watson Genna, IBCLC  NYC

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