TREATMENT MODALITIES AND OUTCOMES OF IDIOPATHIC GRANULOMATOUS MASTITIS

Azhin H. Tofiq A. Qadir a and Kamal A. Saeed b



a Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 
b Ashty Hospital, Soran.


Submitted: 11/5/2019; Accepted: 16/2/2020; Published: 21/3/2020

ABSTRACT


Background 

Idiopathic Granulomatous Mastitis (IGM) is a benign chronic inflammatory breast disease. The etiologies of IGM are presently unclear, that is why treatment is still a challenge, Medical therapy, Wide Local Excision(WLE), abscess drainage, and even mastectomy were introduced to treat this disease.


Objectives 

To review clinical, diagnostic features and outcomes of treatments, also to indicate which method can be practical for treatment of IGM.


Patients and Methods

This study is retrospective in which prospectively maintained in Breast Clinic in Sulaimani city. Ninety-three (93) female patients with histopathologically proved IGM and treated from 1st January 2014 till 15th March 2019. Mostly Core needle biopsy(CNB) and excisional biopsy were used for accurate diagnosis. Plans of the treatment were designed according to the presentations and results of the histopathology.


Results

The baseline characteristics of 93 female patients revealed that the average age of the patients was 35.73±7.96 SD years old with the majority of patients (75%) being between 21 and 40 years old. Based on Fine Needle Aspiration Cytology (FNAC), Core Needle Biopsy and excisional biopsy, they were diagnosed with Idiopathic Granulomatous Mastitis. Medical and surgical therapies included use of antibiotic alone in 18(19.3%) cases, steroid in 26(28%) cases, anti-prolactin in 14 (15%) cases. One 1 (1%) of the patients underwent mastectomy, 39 (42%) of them underwent wide local excision after medical treatments failure, and 8 (8.6%) of them who had abscesses were drained. The overall cure rate in both treatment modalities were 75 (81%) and recurrence rate of 18 (19%).


Conclusion

There is still no standard treatment for IGM, the results of this study concluded that wide local excision is the best treatment of choice. Most of the patients do not respond to one treatment modality and recurrence is common; that’s why the disease is called ‘idiopathic.’ Thus, there are no known causes to have an effective treatment modality



KEYWORDS

Idiopathic Granulomatous Mastitis, Treatment modalities, Outcomes.