Granulomatous mastitis: A retrospective review of 49 patients

Yıl 2015, Cilt: 42 Sayı: 1, 22 - 27, 09.05.2015

Sadullah Girgin , Ömer Uslukaya Edip Yılmaz Uğur Fırat Hatice Gümüş Murat Kapan Metehan Gümüş

https://doi.org/10.5798/diclemedj.0921.2015.01.0524

Cited By: 5

Öz

Objective: Idiopathic granulomatous mastitis, a rare, benign, chronic inflammatory condition of the breast, which usually mimics breast carcinoma. In this study, we report on the management of 49 cases of idiopathic granulomatous mastitis and their clinical presentation. Methods: The breast and anatomical databases of one center were reviewed from 2007 to 2012 to identify patients with histological diagnosis of idiopathic granulomatous mastitis. Clinical and demographic characteristics were retrieved and treatment modalities were were recorded. Results: The mean patient age was 37.71±7.1 years. There were no differences between the management groups about etiological and demographic factors. The rate of recurrence in group 1, group 2, and group 3 was 8.3%, 14.8% and 20%, respectively; there were no statistically significant difference among the groups. Conclusion: Steroids and surgical methods codified in idiopathic granulomatous mastitis may be preferred. We recommend steroid therapy as first-line treatment. However, prospective, randomized clinical trials are needed to determine the treatment algorithm. Key words: Idiopathic, granulomatous, mastitis, management

Anahtar Kelimeler

Idiopathic, granulomatous, mastitis, management

Granülamatöz mastit: 49 hastanın retrospektif incelenmesi

Öz

Amaç: İdiopatik granulomatöz mastit, nadir görülen, benign, kronik inflamatuar bir hastalık olup meme kanserini taklit eder. Bu çalışmada idiopatik mastitli 49 hastanın tedavisini ve kliniğini sunmayı amaçladık. Yöntemler: Hastane otomasyon sisteminde 2007-2012 yılları arasında histolojik olarak granulomatöz tanısı konulmuş hastalar incelendi. Hastalara ait klinik bulgular, demografik veriler ve tedavi yöntemleri kaydedildi. Bulgular: Ortalama yaş 37.71±7.1 idi. Tedavi gruplar arasında etiyolojik ve demografik açıdan istatistiksel fark yoktu. Nüks oranları grup 1, grup 2 ve grup 3’te sırasıyla %8,3, %14,8 %20 olup, gruplar arasında istatistiksel anlamlı farklılık yoktu. Sonuç: Steroid ve cerrahi tedavinin idiopatik granulomatöz mastitli hastalarda uygulanabileceğini, steroid tedavisinin ilk basamak tedavi olması gerektiği kanaatindeyiz. Bununla birlikte tedavi algoritması belirlenebilmesi için prospektif, randomize klinik çalışmalara ihtiyaç vardır

Anahtar Kelimeler

İdyopatik, granülamatöz mastit, tedavi

Kaynakça

• DeHertogh DA, Rossof AH, Harris AA, Economou SG. Prednisone
• management of granulomatous mastitis. N Engl J Med
• ;303:799-800.
• Fletcher A, Magrath IM, Riddell RH, Talbot IC. Granulomatous mastitis:
• a report of seven cases. J Clin Pathol 1982;35:941-945.
• Going JJ, Anderson TJ, Wilkinson S, Chetty U. Granulomatouslobular
• mastitis J Clin Pathol 1987;40:535-540.
• Jorgensen MB, Nielsen DM. Diagnosis and treatment of granulomatous
• mastitis. Am J Med 1992;93:97-101.
• Skandarajah A, Marley L. Idiopathic granulomatous mastitis:a medical
• or surgical disease of the breast? ANZ J Surg 2014; 24:234-239.
• doi: 10.1111/ans.12929.
• Afridi SP, Memon A, Shafiq-ur-Rahman, Memon A. Granulomatous
• mastitis: a case series. J Coll Physicians Surg Pak 2010;20:365-
• -
• Sellitto A, Santoriello A, De Fanis U, et al. Granulomatous lobular
• mastitis: another manifestation of systemic lupus erythematosus?
• Breast J 2013;19:331-332.
• Gurleyik G, Aktekin A, Aker F, et al. Medical and surgical treatment
• of idiopathic granulomatous lobular mastitis: a benign inflammatory
• disease mimicking invasive carcinoma. J Breast Cancer
• ;15:119-123.
• Bani-Hani KE, Yaghan RJ, Matalka II, Shatnawi NJ. Idiopathic
• granulomatous mastitis: Time to avoid unnecessary mastectomies.
• Breast J 2004;10:318-322.
• Kok KY, Telisinghe PU. Granulomatous mastitis: presentation,
• treatment and outcome in 43 patients. Surgeon 2010;8:197-201.
• Sakurai K, Fujisaki S, Enomoto K, et al. Evaluation of follow-up
• strategies for corticosteroid therapy of idiopathic granulomatous
• mastitis. Surg Today 2011;41:333-337.
• Altintoprak F, Kivilcim T, Ozkan OV. Aetiology of idiopathic
• granulomatous mastitis. World J Clin Cases 2014;2:852-858. doi:
• 12998/wjcc.v2.i12.852.
• Erhan Y, Veral A, Kara E, et al. A clinicopathologic study of a rare
• clinical entity mimicking breast carcinoma: idiopathic granulomatous
• mastitis. Breast. 2000;9:52-56.
• Asoglu O, Ozmen V, Karanlik H, et al. Feasibility of surgical
• management in patients with granulomatous mastitis. Breast J
• ;11:108-114.
• Lai ECH, Chan WC, Ma TK, et al. The role of conservative treatment
• in idiopathic granulomatous mastitis. Breast J 2005;11:454-
• -
• Casteren CV, Jacquemyn Y, Himpe E, Verslegers I. Idiopathic ganulomatous
• mastitis. BMJ Case Rep 2012. doi: 10.1136/bcr-2012-
• -
• Ocal K, Dag A, Turkmenoglu O, et al. Granulomatous mastitis:
• clinical, pathological features, and management. Breast J.
• ;16:176-182.
• Gautier N, Lalonde L, Tran-Thanh D, et al. Chronic granulomatous
• mastitis: Imaging, pathology and management. Eur J Radiol.
• ;82:e165-175.
• Ozel L, Unal A, Unal E, et al. Granulomatous mastitis: is it autoimmune
• disease? diagnostic and therapeutic dilemmas. Surg Today
• ;42:729-733.
• Kiyak G, Dumlu EG, Kilinc I, et al. Management of idiopathic
• granulomatous mastitis: dilemmas in diagnosis and treatment.
• BMC Surg 2014;14:66. doi: 10.1186/1471-2482-14-66.
• Salehi M, Salehi H, Moafi M, et al. Comparison of the effect of
• surgical and medical therapy for the treatment of idiopathic granulomatous
• mastitis. J Res Med Sci. Mar 2014;19:5-8.
• Memis A, Bilgen I, Ustun EE Ozdemir N, et al. Granulomatous
• mastitis: imaging findings with histopathologic correlation. Clin
• Radiol 2002;57:1001-1006.
• Wilson JP, Massoll N, Marshall J, et al. Idiopathic granulomatous
• mastitis: in search of a therapeutic paradigm. Am Surg.
• ;73:798-802.
• Heer R, Shrimankar J, Griffith CDM. Granulomatous mastitis can
• mimic breast cancer on clinical, radiological or cytological examination:
• a cautionary tale. Breast 2003;12:283-286.
• Guven HE, Pak I, Oral S. Granulomatous mastitis: surgical outcomes.
• J Coll Physicians J Coll Physicians Surg Pak 2006;16:431-
• -
• Joseph KA, Luu X, Mor A. Granulomatous Mastitis: A New York
• Public Hospital Experience. Ann Surg Oncol 2014. doi:10.1245/
• s10434-014-3895-z.
• Al-Khaffaf B, Knox F, Bundred NJ. Idiopathic granulomatous mastitis:
• a 25-year experience. J Am Coll Surg 2008;206:269-273.
• Pereira FA, Mudgil AV, Macias ES, Karsif K. Idiopathic granulomatous
• lobular mastitis. Int J Dermatol 2012;51:142-151.
• Pandey TS, Mackinnon JC, Bressler L, et al. Idiopathic granulomatous
• mastitis - a prospective study of 49 women and treatment
• outcomes with steroid therapy. Breast J 2014;20:258-266.