Integrative Traditional Chinese Medicine Approaches for Plasma Cell Mastitis: Clinical Efficacy and Mechanistic Insights—A Narrative Review

Abstract

Background Plasma cell mastitis (PCM) is a chronic nonlactational inflammatory breast disease characterized by recurrent inflammation, abscesses, sinus tracts, fibrosis, and high recurrence risk. Current treatments mainly target symptoms and complications but may not fully address underlying inflammatory, immune, and tissue-remodeling mechanisms. Traditional Chinese medicine (TCM) has gained attention as a complementary approach due to its multicomponent and multitarget properties. Methods A narrative review was conducted using PubMed/MEDLINE, Scopus, Web of Science, Embase, Google Scholar, China National Knowledge Infrastructure, WanFang Data, and VIP databases. English- and Chinese-language clinical, experimental, and mechanistic studies available up to June 2026 were reviewed. Evidence was qualitatively synthesized, with priority given to PCM-specific studies, while findings from related inflammatory or fibrotic diseases were considered indirect evidence. Results Current evidence suggests that Chinese herbal medicine, acupuncture, moxibustion, external herbal therapy, and integrated TCM–Western medicine may improve symptom control, inflammation resolution, wound healing, postoperative recovery, and recurrence management. However, available studies are mainly small-scale, single-center, observational, or retrospective, limiting evidence quality. Proposed mechanisms involve modulation of inflammatory cytokines, immune responses, macrophage polarization, NF-κB, PI3K/Akt, MAPK, NLRP3 inflammasome signaling, oxidative stress, fibrosis, and tissue repair, although PCM-specific validation remains limited. Conclusions TCM may serve as a potential adjunctive strategy for PCM by regulating inflammation, immune imbalance, fibrosis, and tissue repair. However, definitive efficacy and superiority remain unconfirmed. Large-scale multicenter randomized trials, standardized protocols, long-term recurrence evaluation, validated biomarkers, and PCM-specific mechanistic studies are needed.