Idiopathic granulomatous mastitis: factors influencing recovery and recurrence

Yıl 2019, , 768 - 775, 04.09.2019

Hüseyin Onur Aydın Ataç Baykal Ali Konan Volkan Kaynaroğlu

https://doi.org/10.18621/eurj.424016

Cited By: 1

Öz

Objectives:
Idiopathic granulomatous mastitis
(IGM) is an idiopathic, inflammatory, and benign disease of the breast. The aim
of this study was to determine possible risk factors for the recurrence of IGM
in patients treated with different treatment modalities.

Methods: It
was planned to explore the risk factors of the disease through the evaluation
of the medical records of 81 patients with the relevant diagnosis in the
archives of Hacettepe University. The medical records of the patients were
retrospectively screened for information regarding age, sex, total number of pregnancies,
duration of breastfeeding, rheumatologic diseases, size and recurrence of the
radiologically detected lesions. The results of two-year follow-up of the
patients after the treatment were evaluated. The rates of recovery and
recurrence after the treatment were determined for patients who received
antibiotic therapy alone, who underwent wide excision alone, who received
antibiotic therapy in combination with steroid therapy, and who received added
azathioprine and/or methotrexate therapy.

Results: No
significant difference was observed between 12 patients having recurrence and
69 patients having no recurrence. However, the recovery time was shorter for
patients with a lesion size of ≤ 20 mm who underwent wide excision or received
antibiotic therapy alone.

Conclusion: Among
patients with a mass size ≤ 20 mm, those treated with wide excision and
antibiotic therapy alone had shorter recovery times compared with those who
received immunosuppressive therapy. In addition, it may take more than two
years to terminate the treatment in patients who received medical treatment
alone.

Anahtar Kelimeler

idiopathic granulomatous mastitis, recovery, recurrence, treatment, breast

Kaynakça

• [1] Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 1972;58:642-6.
• [2] Baslaim MM, Khayat HA, Al-Amoudi SA. Idiopathic granulomatous mastitis: A heterogeneous disease with variable clinical presentation. World J Surg 2007;31:1677-81.
• [3] Ozel L, Unal A, Unal E, Kara M, Erdoğdu E, Krand O, et al. Granulomatous mastitis: is it an autoimmune disease? Diagnostic and therapeutic dilemmas. Surg Today 2012;42:729-33.
• [4] Taylor GB, Paviour SD, Musaad S, Jones WO, Holland DJ. A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology 2003;35:109-19.
• [5] Akcan A, Akyildiz H, Deneme MA, Akgun H, Aritas Y. Granulomatous lobular mastitis: A complex diagnostic and therapeutic problem. World J Surg 2006;30:1403-9.
• [6] Hugon-Rodin J, Plu-Bureau G, Hugol D, Gompel A. Management of granulomatous mastitis: a series of 14 patients. Gynecol Endocrinol 2012;28:921-4.
• [7] Raj N, Macmillan RD, Ellis IO, Deighton CM. Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology 2004;43:1055-6.
• [8] Kim j, Tymms KE, Buckingham JM. Methotrexate in the management of granulomatous mastitis. ANZ J Surg 2003;73:247-9.
• [9] Ocal K, Dag A, Turkmenoglu O, Kara T, Seyit H, Konca K. Granulomatous mastitis: clinical, pathological features, and management. Breast J 2010;6:176-82.
• [10] Tavassoli FA. Idiopathic granulomatous mastitis. In: Tavassoli FA, eds. Pathology of the Breast. 2nd ed. New York, NY: McGraw-Hill. 1999:793-794.
• [11] Erhan Y, Veral A, Kara E, Ozdemir N, Kapkac M, Ozdedeli E, et al. A clinicopathologic study of a rare clinical entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast 2000;9:52-56.
• [12] Reddy KM, Meyer CE, Nakdjevani A, Shrotria S. Idiopathic granulomatous mastitis in the male breast. Breast J 2005;11:73.
• [13] Tse GM, Poon CS, Ramachandram K, Ma TK, Pang LM, Law BK, et al. Granulomatous mastitis: a clinicopathological review of 26 cases. Pathology 2004;36:254-7.
• [14] Gal-Gombos EC, Esserman LE, Weisberg S. Granulomatous mastitis. J Womens Imaging 2004;6:136-9.
• [15] Kaur AC, Dal H, Muezzinoglu B, Paksoy N. Idiopathic granulomatous mastitis. Report of a case diagnosed with fine needle aspiration cytology. Acta Cytol 1999;43:481-4.
• [16] DeHertogh DA, Rossof AH, Harris AA, Economou SG. Prednisone management of granulomatous mastitis. N Engl J Med 1980;303:799-800.
• [17] Patel RA, Strickland P, Sankara IR, Pinkston G, Many W Jr, Rodriguez M. Idiopathic granulomatous mastitis: case reports and review of literature. J Gen Intern Med 2010;25:270-3.
• [18] Mathelin C, Riegel P, Chenard MP, Tomasetto C, Brettes JP. Granulomatous mastitis and corynebacteria: clinical and pathologic correlations. Breast J 2005;11:357.
• [19] Lai EC, Chan WC, Ma TK, Tang AP, Poon CS, Leong HT. The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 2005;11:454-6.
• [20] Konan A, Kalyoncu U, Doğan Ü, Kılıç YA, Karakoç D, Akdogan A, et al. Combined long-term steroid and immunosuppressive treatment regimen in granulomatous mastitis. Breast Care 2012;7:297-301.
• [21] Yau FM, Macadam SA, Kuusk U, Nimmo M, Van Laeken N. The surgical management of granulomatous mastitis. Ann Plast Surg 2010;64:9-16.
• [22] Yabanoğlu H, Çolakoğlu T, Belli S, Ataç HO, Bolat FA, Pourbagher A, et al. A comparative study of conservative versus surgical treatment protocols for 77 patients with idiopathic granulomatous mastitis. Breast J 2015;21:363-9.