Granulomatous mastitis in pregnancy

Goldberg, Jay; Baute, Lisa; Storey, Leslie; Park, Pauline

doi:10.1016/s0029-7844(00)01051-6

Cited by 41 publications

(43 citation statements)

References 7 publications

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“…Evidence in the literature has shown that most patients with granulomatous mastitis have a troublesome course of recurrence and unfortunately the original treatment of multiple surgical intervention has been associated with increased rates of wound infection, sinus formation and poor cosmesis 6,7 , 9 . Over the last 20 years the use of prednisone alone in high doses has been shown to have a good response 15−18 and this fits in with the autoimmune aetiology hypothesis, but there has been a tendency for side‐effects and we have found that relapses can occur when reduced to the lower doses. We have found that the use of methotrexate in conjunction with prednisone is excellent in that it enabled 100% of patients in the present series to come off prednisone without relapse and then stay in remission.…”

Section: Discussionsupporting

confidence: 70%

“…Usually no further therapy is required thereafter but recurrence and delayed wound healing can occur relatively commonly. More recently, the use of corticosteroids has been shown to be effective, especially in refractory or recurrent cases 15−18 . However, corticosteroids do have major side‐effects, the efficacy has been shown to be variable and recurrences have occurred when the steroids have been withdrawn.…”

Section: Introductionmentioning

confidence: 99%

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Methotrexate in the management of granulomatous mastitis

Kim

Tymms

Buckingham

2003

ANZ Journal of Surgery

111

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Granulomatous mastitis is a rare benign inflammatory breast disease that often clinically simulates carcinoma. Surgical resection of the entire lesion has been the main method of treatment but recurrence, infection, sinus formation and delayed wound healing can occur relatively commonly. Corticosteroids are also effective in recurrent or resistant cases but are associated with side-effects and relapse of disease after steroid withdrawal. A low weekly oral dose of methotrexate was used in five resistant cases after surgery plus corticosteroid. All cases achieved remission, withdrawal of corticosteroid without relapse and no methotrexate side-effect.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Methotrexate in the management of granulomatous mastitis

Kim

Tymms

Buckingham

2003

ANZ Journal of Surgery

111

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“…Before diagnosing IGM, any known cause of granulomatous breast inflammation, such as duct ectasia, sarcoidosis, Wegener's granulomatosis, giant cell arteritis, polyarteritis nodosa, tuberculosis, syphilis, corynebacterial infection, cat-scratch disease in breast lymph node tissue, mycotic infection, granulomatous reaction in a carcinoma and foreign body reaction, whether infectious or non-infectious, should be ruled out [5-7]. Duct ectasia can mimic IGM as both possess similar clinical symptoms, including nipple retraction, pain, and occasional bloody discharge.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia

Lin¹,

Hsu

Tsao

et al. 2012

Diagn Pathol

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Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease. The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8120093785928228

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“…The disease usually occurs around 2 years after breastfeeding at a median age of 30 years [6]. Only 2 reports of male GM [7,8] and a few reports of women developing GM during pregnancy or lactation exist [9,10]. …”

Section: Prevalence and Etiologymentioning

confidence: 99%

Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge

et al. 2018

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Granulomatous mastitis (GM) is a rare benign inflammatory breast disease that affects mostly women of childbearing age with a history of breastfeeding. The etiopathogenesis is still unknown; however, inflammation as the result of a reaction to trauma, metabolic or hormonal processes, autoimmunity, and an infection with Corynebacterium kroppenstedtii have all been implicated. Clinical findings are pain, mass, hyperemia, and inflammation. Because the clinical presentation can mimic infectious mastitis or inflammatory carcinoma, the disease course is often protracted. The diagnosis is made by histopathology. Biopsies show a granulomatous formation in combination with a localized infiltration of multi-nucleated giant cells, epithelioid histiocytes, and plasma cells. Ultrasound, mammography, and magnetic resonance imaging are not specific; however, ultrasound and mammography should be done to exclude other pathologies. Due to the lack of data including randomized controlled studies, the management of GM is controversial. In Western industrialized countries, most authors use a therapy regimen starting with antibiotics and corticosteroids, followed by continuous steroid therapy and surgery in patients with persisting symptoms. More data are needed to define the best therapy. The role of immunotherapy has not yet been ascertained. The implementation of a registry to collect more information on this rare disease is highly recommended.

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Granulomatous mastitis in pregnancy

Abstract: Granulomatous mastitis is diagnosed clinically and histologically. Early recognition and initiation of steroid treatment might prevent repetitive, deforming breast biopsies.

Cited by 41 publications

References 7 publications

Methotrexate in the management of granulomatous mastitis

Methotrexate in the management of granulomatous mastitis

Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia

Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge

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