REVIEW article

Front. Med.

Sec. Precision Medicine

Granulomatous Mastitis: From Localized Inflammation to Systemic Immune-Mediated Disorder

  • 1. Zhejiang Chinese Medical University, Hangzhou, China

  • 2. Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, China

  • 3. Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, China

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Abstract

Granulomatous mastitis (GM) is a chronic inflammatory breast disease of unknown etiology, characterized by a high recurrence rate and challenging clinical management. This review reconceptualizes GM as an immune-mediated disorder and delineates the aberrant crosstalk between innate and adaptive immunity that constitutes its core pathogenesis. We emphasize that hyperprolactinemia acts as a pivotal driver, initiating a pro-inflammatory cascade characterized by macrophage M1 polarization, neutrophil extracellular trap (NET) release, NK cell activation, and severe disruption of T and B cell homeostasis. Currently, glucocorticoids (GCs) are routinely used in the treatment of Granulomatous mastitis, but their efficacy is limited and they cannot fulfill all the needs of clinical treatment. Therefore, it has become imperative to adopt immunomodulatory strategies for treatment. By synthesizing the evolving understanding of GM's immunopathology, this review aims to bridge the gap between mechanistic insights and clinical practice. We critically assess current and emerging therapeutics, including the potential role of Traditional Chinese Medicine (TCM), and propose a framework for future targeted therapeutic strategies that modulate specific immune pathways in GM.

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Keywords

Breast, Breast inflammation, Granulomatous Mastitis, Immune System, Prolactin, Traditional Chinese Medicine

Received

15 November 2025

Accepted

13 February 2026

Copyright

© 2026 Dong, Wang, Zhang, Zhang, Liu, Lei and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Hong Zhao

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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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