Systemic vasculitis involving the breast: a case report and literature review
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Systemic vasculitis involving the breast is a rare clinical condition and may mimic breast cancer or mastitis clinically or radiographically. Here, we report a case of polyarteritis nodosa (PAN) with breast involvement and perform a literature review of published cases of systemic vasculitis affecting the breast to better understand this disorder. We report a case of PAN affecting the right breast in a young woman. A retrospective review was performed by searching Medline, Embase, Web of Science, the Cochrane Library, and Scopus for cases of systemic vasculitis involving the breast written in English up to June 1st, 2018. A 27-year-old woman presented with a painful mass in the right breast was diagnosed as PAN by the biopsy. She was treated with prednisone and methotrexate for 6 months, at which time her condition had stabilized and inflammatory markers had normalized. A total of 66 cases were identified, with granulomatosis with polyangiitis (GPA), giant cell arteritis (GCA), and PAN as the main types. The typical manifestation was mass (79.2%, 53/67) in the breast, and all diagnoses were made by the pathology of the breast biopsy. Glucocorticoid and immunosuppressant were the main therapies, and 74.6% (50/67) patients achieved remission during follow-up. Our case and a literature review of 66 cases of systemic vasculitis involving the breast reveal the importance of tissue biopsy to obtain a definitive diagnosis, because the vasculitis subtype strongly influences prognosis.
KeywordsSystemic vasculitis Breast
We thank Anne M. O’Rourke, PhD, from Liwen Bianji, Edanz Group China (http://www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.
JR has finished the search of the literatures, analysis of the data, and the writing of the whole manuscript. JL and JS are pathologists who made the diagnosis of the biopsy of the patient’ breast and skin tissues. JZ is the physician who treated this patient and made the search of the literatures. JZ is the corresponding author of the manuscript who guided the writing and made the corrections of the whole paper. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
Compliance with ethical standards
Conflict of interest
Jiaqi Ren, Jianying Liu, Jing Su, Jingfeng Zhang, and Jinxia Zhao declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. All authors fulfilled the ICMJE authorship criteria.
Written informed consent was obtained from the patient prior to submission of this article for consideration as a case-based review.
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