Memenin Enfeksiyöz ve İnflamatuar Hastalıkları
Özet
Memenin enfeksiyöz ve inflamatuar hastalıkları; laktasyonel, nonlaktasyonel, granülomatöz, postoperatif mastitler ve inflamatuar meme kanseri olmak üzere farklı gruplarda incelenmektedir. Emzirme döneminde sık rastlanan laktasyonel mastitlerin temel nedeni süt stazı olup, en sık etken mikroorganizma Staphylococcus aureus'tur. Nonlaktasyonel mastitler ise hidradenitis supurativa, Mondor hastalığı gibi ekstrinsik veya periduktal mastit (Zuska hastalığı) gibi intrinsik nedenlerden kaynaklanabilir. Kronik ve nükslerle seyreden idiopatik granülomatöz mastit tanısında altın standart core biyopsidir ve tedavisinde gözlem, steroidler veya cerrahi yöntemler tercih edilmektedir. Sekonder granülomatöz mastitler arasında yer alan meme tüberkülozu ise özellikle endemik bölgelerde dirençli apseler ve kitlelerle ortaya çıkar. Postoperatif mastitler cerrahi yara, radyoterapi veya implant enfeksiyonlarına bağlı gelişirken, nadir görülen fakat lokal ileri evre bir malignite olan inflamatuar meme kanseri, klinik bulgularıyla bakteriyel enfeksiyonları taklit edebildiği için ayırıcı tanıda mutlaka dikkate alınmalıdır.
Infectious and inflammatory breast diseases are categorized into lactational, nonlactational, granulomatous, postoperative mastitis, and inflammatory breast cancer. Lactational mastitis, frequently observed during breastfeeding, is primarily caused by milk stasis, with Staphylococcus aureus being the most common pathogen. Nonlactational mastitis can arise from extrinsic causes like hidradenitis suppurativa and Mondor’s disease, or intrinsic factors such as periductal mastitis (Zuska's disease). Idiopathic granulomatous mastitis is a chronic, recurrent inflammatory condition where core biopsy represents the gold standard for diagnosis, and management includes observation, corticosteroids, or surgery. Breast tuberculosis, a form of secondary granulomatous mastitis, manifests with intractable abscesses and masses, particularly in endemic regions. Postoperative mastitis develops secondary to surgical wounds, radiotherapy, or breast implant infections. Lastly, inflammatory breast cancer is a rare but locally advanced malignancy that mimics bacterial infections due to clinical findings like erythema and edema, making its exclusion critical in differential diagnosis.
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