OUP accepted manuscript

A 47-year-old parous, Hispanic woman who had undergone left mastectomy for ductal breast carcinoma in situ and right mastopexy for cosmesis presented for a 6-month follow-up breast magnetic resonance imaging (MRI). Images of the right breast showed ductal enhancement extending into the nipple and multiple ring-like, non-mass enhancement regions (Figure 1). An MRI-guided biopsy of the right breast was performed, and pathology results showed moderate periductal lymphohistiocytic chronic inflammation. Four weeks after the biopsy, the patient developed indurated, tender wounds in the inframammary fold region of the right breast and in the biopsy site that drained milky fluid, which progressed despite empiric antibiotics. Subsequently, she underwent debridement of the right breast, and was noted intraoperatively to have multiple tracts, purulence, and stigmata suspicious for chronic infection. Tissue was obtained for cultures and histopathology evaluation (Figure 2). What is your diagnosis? Cystic neutrophilic granulomatous mastitis (CNGM) associated...