Granulomatous Mastitis: A Ten-Year Experience at a University Hospital

Abstract

Objective: In this study we aimed to define clinical, radiologic and pathological specialties of patients who applied to General Surgery Department of Atatürk University Medical Faculty with granulomatous mastitis and show medical and surgical treatment results. With the help of this study we will be able to make our own clinical algorithm for diagnosis and treatment. Materials and Methods:We searched retrospectively addresses, phone numbers and clinical files of 93 patients whom diagnosed granulomatous mastitis between a decade of January 2001 -December 2010. We noted demographic specialties, ages, gender, medical family history, main complaints, physical findings, radiological and laboratory findings, medical treatments, postoperative complications and surgical procedures if they were operated; morbidity, recurrence and success ratios, complications after treatment for patients discussed above. Results:In this study we evaluated 93 patients, 91 females and 2 males, with granulomatous mastitis retrospectively who applied to General Surgery Department of Atatürk University Medical Faculty between January 2001 and December 2010. Mean age was 34.4 years. The diagnosis was confirmed by histopathologic examination of the lesions. Seventy three patients had idiopathic granulomatous lobular mastitis and 20 patients had specific granulomatous mastitis IGM (18 tuberculosis mastitis, 1 alveolar echinococcosis and 1 silk reaction). All the patients had surgical debridement or antibiotic, and anti-inflammatory treatment with results bad clinical response before applied our clinic. Conclusion:Empiric antibiotic therapy and drainage of the breast lesions are not enough for complete remission of idiopathic granulomatous mastitis. The lesion must be excised completely. In selected patients, corticosteroid therapy can be useful. In the patients with tuberculous mastitis, abscess drainage and antituberculous therapy can be useful, but wide excision must be chosen for the patients with recurrent disease. Keywords: Mastitis, granulomatous mastitis, tuberculosis mastitis ÖzetAmaç: Atatürk Üniversitesi Tıp Fakültesi genel cerrahi kliniğine baş-vuran ve granülomatöz mastit tanısı alan hastaların klinik, patolojik ve radyolojik özelliklerini belirlemek ve bu hastaların medikal ve cerrahi tedavi sonuçlarını bildirmektir. Bu sayede tanı yöntemleri ve tedavi algoritması üzerinde kliniğimiz deneyimine göre hareket etmek mümkün olacaktır. Gereç ve Yöntem:Ocak 2001 -Aralık 2010 arasındaki 10 yıllık dönem-de histopatolojik olarak granülomatöz mastit tanısı alan 93 olgunun hastane dosyalarına, adres ve telefon kayıtlarına ulaşıldı, dosyaları retrospektif olarak incelendi. Olguların demografik özellikleri yaşları, cinsiyeti, aile hikayesi, şikayetleri, fizik muayene bulguları, radyolojik ve laboratuvar bulguları, medikal tedavisi, ameliyat edilmiş ise ameliyatın şekli, ameliyat sonrası komplikasyonlar, tedavi sonrası morbidite ve nüks oranları not edildi, başarı oranları ve komplikasyonları çıkarıldı.Bulgular: Çalışma yaşları 20 ile 73...

Surgical treatment of granulomatous mastitis: Our experience in Bahrain

“…Granulomatous mastitis is a rare, benign inflammatory breast disease of unknown etiology, mainly affecting women of childbearing age. Although it presents with features of an abscess, it can be mistaken for breast cancer . Several factors have been attributed as causative agents in the literature .…”

“…In our study, only 2 patients had high prolactin levels, but neither developed recurrence in the follow‐up period. Granulomatous mastitis is more common among women of reproductive age, particularly those taking OCPs and patients with recent pregnancy or lactation, however, there have been studies showing GM occasionally occurring in postmenopausal patients, nulliparous women, females not on hormonal therapy or even males . In this case series, 5 patients were postmenopausal, none of our patients had recent use of OCPs and only four patients were breastfeeding at the time of diagnosis.…”

“…Although the etiology of GM is unknown, it has been postulated that GM could result from possible damage to the ductal epithelium produced by local trauma, chemical irritation, and infection, which may allow the extravasation of luminal and protein‐rich secretions into the lobular connective tissue, causing a granulomatous response with lymphocyte and macrophage migration . Autoimmune disease is often implicated in the pathogenesis of GM, due to its occurrence in young females, similarity to other autoimmune disease and its response to steroids and immunosuppressant agents .…”

“…Although it can mimic breast cancer, there is no pathognomonic sign for GM on US, mammography, and MRI . US findings suggestive of GM are heterogenous, irregular, hypoechoic lesions with focal posterior shadowing and tubular extensions, as in our study, but these features are not always present .…”

Idiopathic Granulomatous Lobular Mastitis in a Male Breast: A Case Report

“…Gynecomastia is the most common benign breast pathology in male breasts, with a reported prevalence of approximately 4% in the age group of 10-19 years, and it has been found in up to 55% of male breasts in one autopsy specimen series (10). Mastitis, a benign breast inflammation, is exceedingly rare in men with only three cases reported in the literature to date as a case report or original article (9,11). IGLM is a rare, benign inflammatory disease of the breast that mainly affects women of reproductive age (5,7,12).…”