IMMUNE-MEDIATED DISEASES OF THE BREAST

Immune-mediated diseases of the breast represent a minor but important group of conditions that sit at the crossroads of breast pathology and systemic autoimmunity. Because they are relatively rare and unfamiliar to most clinicians, they are frequently misdiagnosed as infection or malignancy often resulting in delayed diagnosis, unnecessary investigations and sometimes avoidable surgery. These disorders may present as isolated breast disease or as part of a broader autoimmune or vasculitic process, further complicating recognition and management. This review aims to bring together the existing literature on immune mediated breast diseases which include idiopathic granulomatous mastitis, lupus mastitis, lymphocytic mastopathy, IgG4 related mastopathy, sarcoidosis associated mastitis and vasculitis related mastitis. Here, we discuss their common clinical manifestations, overlapping imaging features, typical histopathological findings and current management approaches. Emphasis is placed on the need for careful clinicopathologic correlation, exclusion of differential diagnosis like infection and malignancy, and early multidisciplinary involvement. Greater awareness of these uncommon entities can help clinicians avoid diagnostic pitfalls, limit unnecessary surgical intervention, and ensure timely, appropriate immunomodulatory therapy.