THERAPEUTIC MANAGEMENT OF NON-PUERPERAL MASTITIS

Abstract

Non-puerperal mastitis (NPM) is a benign, heterogeneous, and uncommon inflammatory breast condition, characterized by its occurrence outside the gestational-puerperal cycle, chronic course, and high recurrence rate, significantly impacting quality of life. The most prevalent clinical forms are Periductal Mastitis (PMD), strongly associated with smoking and nipple inversion, and Granulomatous Lobular Mastitis (GLM), linked to autoimmune disorders and hyperprolactinemia. Due to its similarity to breast carcinoma on imaging, histopathological biopsy is considered the gold standard for differential diagnosis and exclusion of malignancy. Therapeutic management, given the absence of a universal protocol, should be multimodal and individualized. Strategies range from conservative treatment (corticosteroids for GLM and antibiotics for PMD) to surgical interventions, indicated in cases of persistent abscesses and recurrence, always aiming to reduce the high recurrence rates. Systemic risk factors (such as diabetes and hypertension), as well as immunometabolic indicators (e.g., elevated fibrinogen and reduced HDL-C), also influence prognosis and recurrence. Thus, the present study aimed to analyze recent scientific evidence on NPM management strategies, highlighting the need for a multidisciplinary approach and strict control of risk factors to ensure favorable outcomes and preservation of breast health.