Clinical Characteristics and Treatment Approach of Idiopathic Granulomatous Mastitis
Abstract
Objectives: The purpose of this study was to evaluate the clinical characteristics, treatment approaches, and outcome of the patients with idiopathic granulomatous mastitis (IGM).
Methods: The patients with IGM were reviewed retrospectively from 2011 to 2017. Event free follow up rate was estimated by using Kaplan-Meier analysis, and follow up differences for prognostic factors were compared by using the log-rank test. Multivariate analysis was performed by using Cox-regression method.
Results: There were 69 patients with histologically proven IGM with median age 34 years (range, 21-68 years) at diagnosis. The majority of the symptoms and signs were breast lump, pain, erythema and axillary lymphadenopathy. The most common extramammary finding was eritema nodosum. The most common treatment approaches were only antibiotic or antibiotic plus drainage. The estimated event free follow up rate was 74.7%. It varied according to parity distribution, erythema, extramammary manifestation, and treatment modalities. Cox regression analysis showed that parity distribution, extramammary manifestation and treatment.
Conclusion: This is one of the largest series in a single center. Factors affecting event free follow up rates were parity, erythema, extrammamary manifestations and treatment modalities.
References
REFERENCES
Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 1972; 58 (6): 642-6.
Benson JR, Dumitru D. Idiopathic granulomatous mastitis: presentation, investigation and management. Future Oncol 2016; 12 (11): 1381-94, http//dx.doi.org/ 10.2217/fon-2015-0038.
Altintoprak F, Kivilcim T, Ozkan OV. Aetiology of idiopathic granulomatous mastitis. World J Clin Cases 2014; 2 (12): 852-8, http//dx.doi.org/10.12998/wjcc.v2.i12.852.
Koksal H. Human leukocyte antigens class I and II in patients with idiopathic granulomatous mastitis. Am J Surg. 2019 Jan 31. pii: S0002-9610(18)31669-6. doi:10.1016/j.amjsurg.2019.01.038.
D’Orsi CJ. ACR BI-RADS atlas: breast imaging reporting and data system. 5ed:American College of Radiology; 2013.
Mahmodlou R, Dadkhah N, Abbasi F, Nasiri J, Valizadeh R. Idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment. Electronic Physician 2017İ 9 (9): 5375-9. http//dx.doi.org/10.19082/5375.
Korkut E, Akcay MN, Karadeniz, Subasi ID, Gursan N. Granulomastous mastitis: a ten-year experience at a university hospital. Eurasian J Med 2015; 47(3): 165-73, http//dx.doi.org/ 10.5152/eurasianjmed.2015.118.
Akin M, Karabacak H, Esendagli G, Yavuz A, Gultekin S, Dikmen K., et al. Coexistence of idiopathic granulomatous mastitis and erythema nodosum: successful treatment with corticasteroids. Turk J Med Sci 2017; 47 (5): 1590-2, http//dx.doi.org/10.3906/sag-1611-100.
Gumus M, Akkurt ZM, Gumus H. Is erythema nodosum coexisting with lesions of the breast a suggestive sign for idiopathic granulomatous mastitis? Turk J Surg 2018; 34 (1): 68-70, http//dx.doi.org/10.5152/turksurg.2017.3161.
Han BK, Choe YH, Park JM, Moon WK, Ko YH, Yang JH, et al. Granulomatous mastitis: mammographic and sonographic appearances. AJR Am J Roentgenol 1999; 173 (2): 317-20, http//dx.doi.org/10.2214/ajr.173.2.10430126.
Yilmaz E, Lebe B, Usal C, Balci P. Mammographic and sonographic findings in the diagnosis of idiopathic granulomatous mastitis. Eur Radiol 2001; 11(11): 2236-40, http//dx.doi.org/10.1007/s003300100965.
Al-Khawari HA, Al-Manfouhi HA, Madda JP, Kovacs A, Sheikh M, Roberts O. Radiologic features of granulomatous mastitis. Breast J 2011; 17 (6): 645-50, http//dx.doi.org/10.1111/j.1524-4741.2011.01154.x.
Bilal A, Badar Albadar F, Bashir Barlas N. Granulomatous mastitis: imaging of tempoeral evolution. Scientifica (Cairo) 2016; 2016: 3737528, http//dx.doi.org/ 10.1155/2016/3737528.
Yilmaz R, Demir AA, Kaplan A, Sahin D, Ozkurt E, Dursun Met al. Magnetic resonance imaging features of idiopathic granulomatous mastitis: is there any contribution of diffusion-weighted imaging in the differential diagnosis? Radiol Med 2016; 121 (11): 857-66, http//dx.doi.org/10.1007/s11547-016-0666-x.
Poyraz N, Emlik GD, Batur A, Gundes E, Keskin S. Magnetic resonance imaging features of idiopathic granulomatous mastitis: a retrospective analysis. Iran J Radiol 2016; 13 (3): e20873. http//dx.doi.org/10.5812/iranjradiol.20873.
Sakurai K, Fujisaki S, Enomoto K, Amano S, Sugitani M. Evalutaion of follo-up strategies for corticosteroid therapy of idiopathic granulomatous mastitis. Surg Today 2011; 41 (3): 333-7, http//dx.doi.org/10.1007/s00595-009-4292-2.