Recent Advances in Pathogenesis, Diagnosis and Integrated Traditional Chinese Medicine Therapy for Plasma Cell Mastitis.

Abstract

Plasma cell mastitis (PCM) is a predominant form of non-lactational mastitis with an increasing incidence worldwide. The condition is characterized by a complex pathogenesis, difficulties in differential diagnosis, and a high rate of recurrence, thereby presenting significant challenges in clinical management. Conventional Western medicine is limited by high postoperative recurrence, difficulty in distinguishing PCM from breast cancer, and unsatisfactory long-term efficacy of single anti-inflammatory or hormone therapy. Against these clinical bottlenecks, Traditional Chinese medicine (TCM) shows unique advantages and accumulated extensive clinical experience for the treatment of PCM. This review systematically delineates the epidemiological characteristics and key pathophysiological mechanisms, including activation of the IL-6/STAT3 signaling pathway, immune cell dysregulation, autoimmune responses, distinctive plasma cell infiltration, and diagnostic methodologies such as imaging techniques, histopathological examination as the diagnostic gold standard, and emerging biomarkers. In addition, the theoretical foundations, contemporary pharmacological mechanisms, and clinical applications of comprehensive TCM therapy for PCM are summarized. Evidence indicates that TCM interventions, guided by syndrome differentiation and targeting liver qi stagnation, phlegm-stasis congealing, and heat-toxin accumulation, exert therapeutic effects by modulating inflammatory signaling pathways, correcting immune dysfunction, and restoring the mammary gland microecological balance. Clinical trials have demonstrated that combining TCM with surgical procedures or western medical treatments significantly improves clinical outcomes, reduces inflammatory mediator levels, and lowers recurrence rates. However, there remains a need for standardization in TCM syndrome differentiation, therapeutic evaluation criteria, and high-quality randomized controlled trials. In summary, integrated TCM therapy constitutes a safe and effective approach for managing PCM, and further rigorous research is warranted to enhance its clinical application and facilitate international recognition of TCM in PCM treatment.