Idiopathic granulomatous mastitis: case report and review of the literature

Abstract

We report a case of idiopathic granulomatous mastitis in a 35-year-old Japanese woman, who came to our hospital complaining of a tender mass in her right breast. Because the results of initial aspiration cytology were considered highly suspicious for carcinoma, modified radical mastectomy was performed. However, the final histological diagnosis was granulomatous lobular mastitis with no evidence of malignancy. Idiopathic granulomatous mastitis is a rare inflammatory breast disease of unknown etiology. Since the clinical manifestations are similar to those of mammary carcinoma, this condition has been misdiagnosed as carcinoma and treated as such. A review of the literature revealed that idiopathic granulomatous mastitis has tended to occur in young patients with a history of childbirth or oral contraceptive usage. Clinical or imaging diagnosis has often been difficult. Complete resection or corticosteroid therapy can be recommended as the optimal treatment. Since 38% of patients experience recurrence, long-term follow-up is indicated.

Bilateral granulomatous mastitis after local nandrolone injection

“…Imoto et al focus on an association of the disease with hormonal changes. In their review, they insist on the time period between a few months to 8 years from delivery to disease presentation, with recent exogenous estrogen suppression of lactation, and the history of OCP use in one third of cases as well [2].…”

“…Many other factors have been postulated as causative, but never proven: local irritants, various infectious agents (viral, mycotic and parasitic), other hormonal disorders (increased serum prolactin), diabetes, smoking, alpha-1 antitrypsin deficiency [1,3,6]. An immune-related pathophysiology due to oozing of secretions from milk ducts into lobules during pregnancy and lactation has been widely considered [1][2][3]. Reports of association of the disease with autoimmune disorders such as erythema nodosum, sarcoidosis, Wegener's granulomatosis, giant cell arteritis, or polyartheritis nodosa strengthens the theory [1,3,6].…”

“…Etiology of the disease is still unrecognized, although its association with various disorders or body milieu changes have been described and discussed in the literature. Hormonal imbalance has been regarded as one of the probable causes, but generally includes female sex hormones [2]. To our knowledge, development of GM in relation to testosterone or its derivatives has not still been reported.…”

“…Granulomatous mastitis (GM) is a rare inflammatory benign breast disease which was first defined by Kessler and Wolloch in 1972 [1][2][3]. Etiology of the disease is still unrecognized, although its association with various disorders or body milieu changes have been described and discussed in the literature.…”

Non-surgical Management in Idiopathic Granulomatous Mastitis

“…It is a rare, nonneoplastic chronic inflammatory disease of the breast [1]. This selflimiting, non-case eating benign disorder also known as Idiopathic Granulomatous Lobular Mastitis, a breast disease of unknown etiology that was first described by Kessler and Wolloch in 1972 [2,3].…”