Autoimmune Mastitis with Gigantomastia Gravidorum: Report of a Case and Review of Literature

Breasts can be the target organ for many autoimmune conditions. Pregnancy is a known trigger for flares of autoimmunity. Sometimes, inflammation limited to the breast is the first symptom of a systemic autoimmune disease. However, due to the rarity of this presentation, the diagnosis of a pregnancy-induced autoimmune breast inflammation can be very difficult. A young woman presented in the 12th week of her pregnancy with persistent symptoms of pain and erythema of the breast. She underwent repeated imaging investigations and received multiple courses of antibiotics without relief. Within a few weeks, she also developed massive enlargement of her breasts. Even though she was evaluated for a possible autoimmune aetiology, the test results could not clinch a diagnosis. In view of the development of gigantomastia by the third trimester, delivery was induced at 30 weeks. Lactation was suppressed with cabergoline. Two weeks after delivery, she started manifesting symptoms of systemic autoimmune disease, and after detailed evaluation, was diagnosed with systemic lupus erythematosus with Sjögren’s syndrome. After appropriate medication, her disease went into remission, and the gigantomastia regressed to near-normal size. A diagnosis of autoimmune mastitis should be kept in mind in patients with persistent inflammation of the breast. An early diagnosis may help detect systemic diseases and initiate a prompt, appropriate therapeutic strategy.