Diagnosis and Treatment of 75 Patients with Idiopathic Lobular Granulomatous Mastitis

Abstract

Idiopathic granulomatous lobular matitis (IGLM) is a rare non-specific inflammatory disease of the breast. Although IGLM is completely benign, it is easily confused with cancer due to progressive breast lump with firmly unilateral and discrete mass, nipple retraction and sinus formation. Patients with IGLM are usually associated with inflammation of the overlying skin. This study aimed to investigate the clinical characteristics of IGLM, treatment options and prognosis. From January 2010 to February 2015, 75 IGLM patients in our hospital were included, with an average age of 35.9 ± 10.0 (range 21-61) years. Most of them were parous. The main clinical characteristic was the presence of a large, irregular and painful mass. Hypoechoic lobulated, irregular tubular or oval shaped masses were detected by breast gland ultrasound. Ill-defined mass, enlarged axillary lymph nodes, asymmetric density, and architectural distortion were found by breast molybdenum palladium X-ray. Diagnosis of IGLM was confirmed with histological examination. The majority (60/75) of the IGLM patients received surgical treatment, including lumpectomy, abscess drainage or mastectomy. Antibiotics were used after surgery. The disease recurred in three patients during the follow-up period. Our study suggested that IGLM diagnosis more depends on CNB and postoperative histopathological examination, and surgery and symptomatic treatment can completely remove the lesions, in order to cure the disease.

Surgical drainage of lactational breast abscess with ultrasound‐guided Encor vacuum‐assisted breast biopsy system

“…However, simple drainage of such abscesses may often result in relapse . Drainage of abscess, extended resection, administration of antibiotics as well as steroid are often required for the treatment of nonpuerperal breast abscess. Considering the optimal management of nonpuerperal mastitis is still under controversy, patients with nonpuerperal breast abscess were not enrolled in our study.…”

Minimally invasive comprehensive treatment for granulomatous lobular mastitis

“…Hovanessian Larsen et al administered an antibiotic treatment, including dicloxacillin, cephalexin, or clindamycin, to 38 patients for 10 days, but only two patients showed improvement [18]. Similarly, the preoperative antibiotic treatment used in 31 cases by Li, et al [8]. was ineffective in 23 cases and none of the patients fully recovered; eight cases showed an effect of antibiotic treatment that was limited to reduction in lump and skin redness, suggesting that GLM may be complicated by pathogen infection and that the use of antibiotics helps to eliminate the relevant infection symptoms.…”

Minimally invasive comprehensive treatment for granulomatous lobular mastitis

“…Hovanessian Larsen et al administered an antibiotic treatment, including dicloxacillin, cephalexin, or clindamycin, to 38 patients for 10 days, but only two patients showed improvement [11]. Similarly, the preoperative antibiotic treatment used in 31 cases by Li, et al [12]. was ineffective in 23 cases and none of the patients fully recovered; eight cases showed an effect of antibiotic treatment that was limited to reduction in lump and skin redness, suggesting that GLM may be complicated by pathogen infection and that the use of antibiotics helps to eliminate the relevant infection symptoms.…”