NON-LACTATIONAL MASTITIS: SURGICAL MANAGEMENT AND MORPHOLOGICALLY GUIDED DECISION-MAKING ALGORITHM

Xayitov Ilkhom Bakhodirovich; Babajonov Akhmadjon Bakhodirovich; Tangriev Shavkat Suvonovich

Authors

Xayitov Ilkhom Bakhodirovich DSc, Associate Professor, Tashkent State Medical University
Babajonov Akhmadjon Bakhodirovich Senior Lecturer, Tashkent State Medical University
Tangriev Shavkat Suvonovich Head of Department, Ibn Sina City Clinical Hospital

Keywords:

Non-lactational mastitis, surgical algorithm, ultrasound-guided aspiration, VAC therapy, pyogenic membrane, periductal mastitis, ductectomy, granulomatous mastitis.

Abstract

This article systematizes current evidence on surgical treatment of non-lactational mastitis (NLM) and substantiates a differentiated operative decision-making algorithm based on ultrasound parameters of the abscess cavity and the morphological maturity of the pyogenic membrane. US-guided aspiration is shown to achieve primary success in 78–85% of cases for abscesses ≤3 cm. It is demonstrated that excision of a mature pyogenic membrane (>4 mm) constitutes a mandatory, non-optional operative component. Surgery combined with steroids is shown to reduce GLM recurrence to 4.0% versus 20.9% with steroid monotherapy, while total ductectomy for periductal mastitis reduces recurrence to 4–8% versus 28–42% with standard drainage. Integration of ultrasound parameters and pyogenic membrane morphological maturity into a unified algorithm is substantiated as an evidence-based approach to improving surgical outcomes in NLM.