Idiopathic granulomatous mastitis: clinical, histopathological, and radiological characteristics and management approaches

Azzam, Muayad I.; Alnaimat, Fatima; Al-Nazer, Majed W; Awad, Heyam; Odeh, Ghada; Al-Najar, Mahasen; Alsayed, Suzan; El-Asir, Layal; Addasi, Rami; Melhem, Jamal Masad; Sweiss, Nadera J.

doi:10.1007/s00296-023-05375-6

Cited by 4 publications

(2 citation statements)

References 47 publications

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“…Histopathological examination of GLM lesion tissue in previous studies has shown that the number of abscess formations was significantly correlated with the inflammatory infiltration, which was manifested by a large number of neutrophil aggregates at the site of the abscess. 34 This is consistent with our serological findings that serum neutrophil levels are positively correlated with GLM abscess formation. Neutrophils are important innate immune cells that can participate in the early host defence response during infection/injury through a variety of pathways, including phagocytosis, degranulation, generation of reactive oxygen species and release of the neutrophil extracellular traps (NETs).…”

Section: Discussionsupporting

confidence: 92%

“…Coskun et al further analysed the changes in cytokine profiles in patients with active and remission GLM, and their results showed that patients with active GLM may have elevated IL-8 and IL-17 and reduced IL-10, but none of these results were significant. 34 Therefore, the authors concluded that cytokines may play a role in autoimmune and granulomatous reactions and have a less significant role in the pathogenesis of GLM. Thus, instead of focusing on the role of cytokines in the pathogenesis of GLM, our study focused on the analysis of cytokine changes during abscess formation.…”

Section: Discussionmentioning

confidence: 99%

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Construction of a Multi-Indicator Model for Abscess Prediction in Granulomatous Lobular Mastitis Using Inflammatory Indicators

Du,

Feng,

Shao

et al. 2024

JIR

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Background Granulomatous lobular mastitis (GLM) is a chronic inflammatory breast disease, and abscess formation is a common complication of GLM. The process of abscess formation is accompanied by changes in multiple inflammatory markers. The present study aimed to construct a diagnosis model for the early of GLM abscess formation based on multiple inflammatory parameters. Methods Based on the presence or absence of abscess formation on breast magnetic resonance imaging (MRI), 126 patients with GLM were categorised into an abscess group (85 patients) and a non-abscess group (41 patients). Demographic characteristics and the related laboratory results for the 9 inflammatory markers were collected. Logistics univariate analysis and collinearity test were used for selecting independent variables. A regression model to predict abscess formation was constructed using Logistics multivariate analysis. Results The univariate and multivariate analysis showed that the N, ESR, IL-4, IL-10 and INF-α were independent diagnostic factors of abscess formation in GLM ( P <0. 05). The nomogram was drawn on the basis of the logistics regression model. The area under the curve (AUC) of the model was 0.890, which was significantly better than that of a single indicator and the sensitivity and specificity of the model were high (81.2% and 85.40%, respectively). These results predicted by the model were highly consistent with the actual diagnostic results. The results of this calibration curve indicated that the model had a good value and stability in predicting abscess formation in GLM. The decision curve analysis (DCA) demonstrated a satisfactory positive net benefit of the model. Conclusion A predictive model for abscess formation in GLM based on inflammatory markers was constructed in our study, which may provide a new strategy for early diagnosis and treatment of the abscess stage of GLM.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Construction of a Multi-Indicator Model for Abscess Prediction in Granulomatous Lobular Mastitis Using Inflammatory Indicators

Du,

Feng,

Shao

et al. 2024

JIR

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The role of tissue IgG4 levels in steroid therapy in patients with idiopathic granulomatous mastitis

Seyidli,

Aydoğdu,

Büyükkasap

et al. 2024

Clin Exp Med

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Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory lesion of the breast. Immunoglobulin G4 (IgG4) associated disease is rare in the breast. In our study, we aimed to evaluate the efficacy of steroid treatment on IgG4 levels in tissue in patients diagnosed with IGM. Between 2008 and 2017, 55 patients diagnosed with IGM in our clinic were included in the study. Demographic, clinical, microbiologic and histopathologic characteristics, treatment modality and recovery time were evaluated retrospectively. Patients were divided into 3 groups according to tissue IgG4 levels: negative (Group I), infrequently and slightly positive (Group II), and highly positive (Group III). Group I patients had a complete response rate of 77.8%. In the rest of the patients (22.2%), insufficient response was detected from the beginning of the treatment. In Group II, the response rate was 91.3% and the permanent success rate after treatment was 87.0%. Although group III patients had a complete response at the beginning (95.65%), they relapsed in a short period of time (26.1%) after discontinuation of steroid treatment. At least one steroid-related side effect was observed in 47 (85.8%) patients in all groups. There is no consensus on the dose and duration of immunosuppressive treatment in IGM. In this study, responses to steroid treatment according to IgG4 concentration in pathologic breast tissue and recurrences after the end of treatment were determined. We think that high IgG4 concentration in the tissue is associated with recurrence and other immunosuppressive drugs should be added as maintenance after steroid treatment.

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Promoting Standardization of Clinical Evidence With Severity-Guided Treatments for Idiopathic Granulomatous Mastitis: A Narrative Review

Gillen,

Leahy

2024

The American Surgeon™

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Idiopathic granulomatous mastitis (IGM) is a benign disease of the breast which causes a great deal of discomfort for patients. More comparable data and greater consensus in treatment are needed to better understand the disease and help with evidence-based clinical decision making. This narrative review aims to discuss the literature available on IGM and illustrate the need for consensus on treatment. We highlight the existing severity scores for this disease in the literature and discuss the value of severity-guided treatment. In our review, 81 studies out of 319 reviewed publications met established criteria. With the selected results from our search results, the available research on IGM etiology, risk factors, diagnosis, and treatment is summarized with an emphasis on the existing severity scores. A total of four proposed severity scores were found in our review. Consensus on the treatment of IGM must be established. There are varying severity scores on IGM severity. We suggest using an established standardized severity score to guide treatment and recommend one such score.

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Idiopathic granulomatous mastitis: clinical, histopathological, and radiological characteristics and management approaches

Cited by 4 publications

References 47 publications

Construction of a Multi-Indicator Model for Abscess Prediction in Granulomatous Lobular Mastitis Using Inflammatory Indicators

Construction of a Multi-Indicator Model for Abscess Prediction in Granulomatous Lobular Mastitis Using Inflammatory Indicators

The role of tissue IgG4 levels in steroid therapy in patients with idiopathic granulomatous mastitis

Promoting Standardization of Clinical Evidence With Severity-Guided Treatments for Idiopathic Granulomatous Mastitis: A Narrative Review

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