Management of Patients with Granulomatous Mastitis: Analysis of 31 Cases

Abstract

Keywords Mastitis · Granulomatous mastitis, idiopathic · TreatmentSummary Background: Granulomatous mastitis is a benign recurrent disease. Accurate diagnosis is only by histopathology. Patients and Methods: 31 cases with histological diagnosis were retrospectively analyzed. Results: Mean follow-up was 42.4 months for recurrent and 27.8 months for non-recurrent cases. Etiology was tuberculosis in 1 case. 5 cases (16%) relapsed. 6 patients (19.3%) treated with abscess drainage healed completely, but 50% relapsed. Relapses were treated with excision or steroids. Steroid therapy was the initial treatment in 12 cases (38.7%), with 1 relapse (8.3%) which was treated in the same manner. 2 patients had incomplete response necessitating excision, and another 2 developed abscesses which were treated with steroids or excision after drainage. Surgical excision was preferred in 12 cases (38.7%) due to suspicion for carcinoma in 8 patients (25.8%) and/or low probability of poor cosmetic outcome. All healed without complication, and recurrence was observed in 1 case (8.3%) which was treated with re-excision. Conclusion: Both excision and steroid therapy had low and similar relapse rates, but excision was superior to steroid therapy in providing strict diagnosis with much faster healing and fewer complications. In refractory cases, and when deformity is inevitable, steroid therapy should be preferred.

Idiopathic Granulomatous Mastitis: Comparison of Wide Local Excision with or without Corticosteroid Therapy

“…It was first described as an entity by Kessler and Wolloch in 1972 [1]. Few articles exist in the literature, most of which are case reports and small series [4,11,12,34]. The etiology of IGM is not clear.…”

“…It also provides significant regression of the inflammatory disease, allowing more conservative surgery. Consecutive surgical excision of the remaining lesions provides definitive treatment and reduces the risk of recurrence [28,29,30]. …”

Strategies to treat idiopathic granulomatous mastitis: Retrospective analysis of 40 patients

“…Besides, surgical excision is another option of treatment of GM, however, still none of these methods is solely accepted as definitive management [5,6,14].…”

“…Partial excisions may lead to recurrences, and are not as beneficial as total excisions. Thus, wide excision of entire lesion is the principle [6,14]. Contrarily, some authors are against this strategy as they believe that wide excision of the lesion results in delayed wound healing and poor cosmesis [1,6].…”

“…Various modalities such as antibiotics and antiinflammatory agents, corticosteroids or surgical excision have been suggested in the treatment of IGM; however, definitive treatment method is still controversial [14].…”