SINGAPORE – Growing up, Mrs Kinnari Bhosale never liked her breasts.
“They have always been on the large side and got in the way whenever I tried to do any sports. I would cuss angrily at them,” the 35-year-old trained architect, who is now a homemaker and mother of twin boys, told The Straits Times.
Mrs Bhosale said it was after she had her sons Anant and Anvay four years ago that her breasts got bigger.
“During my menstrual cycle, they would be sore, but in the past two years, the pain did not go away, even after my period,” she said.
Believing that “it was usual”, she endured the pain until late 2024, when her left breast “was very painful and felt as hard as a hard rock”.
Four-year-old twins Anant (left) and Anvay, seen here with their father, Mr Satyajit Bhosale, know not to play rough with or hug their mother Kinnari Bhosale too tightly as that would cause her pain because of her rare condition.
COURTESY OF KINNARI BHOSALE
Fearing that it was not normal, Mrs Bhosale consulted the general practitioner at her neighbourhood clinic.
“The GP suspected it could be breast cancer and referred me to Dr Jude Lee at Mount Elizabeth Novena Hospital. I went (there) in January this year, and after having gone through a battery of tests and scans, including a mammogram, he could not make out what it was. He told me there were no signs of breast cancer,” she said.
Mrs Bhosale then sought a second opinion from breast surgeon Radhika Lakshmanan from Farrer Park Hospital.
“The battery of tests and scans were repeated. This time, Dr Radhika also did a tissue biopsy to rule out cancer. I was finally diagnosed after three months with granulomatous mastitis (GM),” she said.
GM is a rare chronic inflammatory condition of the breast that is benign and often under-recognised. Most patients affected are women with a mean age of 35, have given birth to one or more children, and have breastfed within five years of diagnosis.
Its symptoms can mirror those of inflammatory breast cancer, including sudden breast swelling and pain, Dr Radhika said.
“The actual cause (of GM) is not known, but is thought to be autoimmune in nature, This means that the breast cells tend to be attacked by the body’s own defence mechanism, as it is recognised as a ‘foreign’ or ‘diseased’ part of the body,” she added.
“The most common underlying cause for this autoimmune inflammation is ‘idiopathic’, meaning there is no known cause found. Less often, it can be due to a general autoimmune condition which the patient has that is causing the breast inflammation.”
Dr Radhika said that studies from the West have shown GM to be present in 2.4 of every 100,000 women aged between 20 and 40, but the “incidence has been reported to be higher in Asian patients”.
Mrs Bhosale’s symptoms were the typical clinical scenario – breast pain with a mass – and her condition was diagnosed after tissue sampling and a biopsy to rule out other serious conditions like breast cancer and certain infectious diseases, including tuberculosis.
She said: “Dr Radhika pointed out that my ESR (erythrocyte sedimentation rate) was 81mm/hr. It meant that I was having significant inflammation in my body. She told me that for a healthy person, it should be below 20mm/hr. My immune system was attacking my body, causing lumps to grow in my left breast.”
In GM, the lumps within the breast tissue often appear as a tender, firm mass, sometimes with redness, swelling, or skin changes.
Mrs Bhosale was given two options: Start biological therapy or seek traditional Chinese medicine treatment, in tandem with Western medication, to get to the root of the problem.
She picked the latter despite it being a long-drawn process.
“But I could not continue (with the treatment) because I woke up one morning and found my bedsheets soaked in blood. Blood and pus were oozing from my left breast. I called Dr Radhika, who put me rather quickly under the knife because she feared there could be an infection,” Mrs Bhosale said.
She had several lumps in her left breast removed.
Post-surgery, Mrs Bhosale had a vacuum suction machine attached to her to remove fluid build-up and promote healing.
PHOTO: COURTESY OF KINNARI BHOSALE
For two months, she had to “wear” a vacuum machine attached to her that helped to remove fluid, reduce swelling and promote healing.
Dr Radhika said GM can last between four months and two years on average.
“It will suddenly stop being active, and the patient will then be disease-free, with no further treatment required,” she said.
However, GM can recur in some patients, even after surgery.
Mrs Bhosale said she felt disappointed when told that “it is a chronic, episodic condition”.
“I was told the surgery removed only the affected tissues but not the underlying cause,” she said.
Still, she noted, “the return rates vary”.
Mrs Bhosale is also seeing a rheumatologist, Dr Sheila Vasoo, for her autoimmune issues.
Besides taking anti-inflammatory medication including painkillers, she has also changed her diet.
“I no longer eat highly processed foods or fried foods. I also avoid wheat and gluten; now I eat only fresh foods and fruits that are high in antioxidants,” she said.
Dr Radhika said a healthy diet seems to play a role in keeping GM at bay. Highly processed food, sugars and oily food are known to trigger inflammation.
Mrs Kinnari Bhosale, a housewife, her husband Satyajit Bhosale and their twin sons, Anant and Anvay, during Deepavali.
PHOTO: COURTESY OF KINNARI BHOSALE
Apart from the diet changes, Mrs Bhosale also had to make some adjustments in her daily life.
“I could no longer pick up my boys or hug them tightly. They know not to rush up to Mummy or play rough with me because it would hurt me,” she said.
“Also, being intimate with my husband is no longer the same, as he is mindful not to hurt me,” she added.
Although she knows that GM might return, Mrs Bhosale said she is grateful for this window where there is not too much pain, discomfort or swelling.
“I am hoping that this window is a long one so that my life with the family can return to normal,” she added.