Investigation and study on pathological diagnosis of granulomatous lobular mastitis in China
Purpose To examine the contemporary state of pathological diagnosis for granulomatous lobular mastitis(GLM)in China.Methods Pathologists from across the nation were invited to engage in an online questionnaire survey,which ad-dressed pertinent topics such as the frequency of GLM diagnosis cases,the modalities of pathology reporting,and advancements in etiological research.The collected data were analyzed utili-zing the x2 test or Fisher's exact test.Results A survey of 702 pathologists included 26.9%(189/702)chief physicians,43.3%(304/702)deputy chief physician,26.1%(183/702)attending physicians,and 3.7%(26/702)residents.Partici-pants were from tertiary general hospitals(77.6%,545/702),traditional Chinese medicine hospitals(7.7%,54/702),ma-ternal and child specialty hospitals(6.1%,43/702),and on-cology specialty hospitals(4.0%,28/702).In 2023,there were over 45,000 mastitis diagnoses.A significantly higher per-centage of chief physicians(60.8%,115/189)and deputy chief physicians(52.6%,160/304)could diagnose specific mastitis types compared to attending and resident physicians(x2=23.537,P<0.001),with"GLM"being the most common diagnosis(55.1%,81/147).In diagnostic work,78.06%(548/702)of pathologists consider patient clinical information,19.2%(135/702)screen specimens for pathogens using special staining,only 6.0%(42/702)of pathologists indicated that their hospitals routinely perform tissue culture for pathogens,with corynebacterium being the most common.Additionally,11.4%(80/702)reported that clinicians regularly test serum sex hormones,most frequently for elevated prolactin,while 7.1%(50/702)check autoimmune status,frequently detecting antibodies without clinical symptoms.Chief physicians had a significantly better understanding of the etiology of GLM com-pared to other physicians(x2=11.969,P=0.003;P=0.007).A majority of pathologists indicated a lack of guidelines for GLM pathology diagnosis(49.4%,347/702)and report standards(76.4%,536/702).Nearly all(97.4%)agreed on the need to establish a consensus for GLM diagnosis.Conclu-sion GLM pathological diagnosis is currently inconsistent and lacks standardization,highlighting the urgent need for a guiding consensus for pathologists.