TREATMENT MODALITIES AND OUTCOMES OF IDIOPATHIC GRANULOMATOUS MASTITIS
DOI:
https://doi.org/10.17656/jsmc.10237Keywords:
Idiopathic Granulomatous Mastitis, Treatment modalities, OutcomesAbstract
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.
References
Gautier N, Lalonde L, Tran-Thanh D, El Khoury M, David J, Labelle M, Patocskai E, Trop I. Chronic granulomatous mastitis: imaging, pathology, and management. European Journal of Radiology. 2013 Apr 1;82(4):e165-75.
Li J. Diagnosis and Treatment of 75 Patients with Idiopathic Lobular Granulomatous Mastitis. Journal of Investigative Surgery. 2018 Jan 29:1-7.
Chirappapha P, Thaweepworadej P, Supsamutchai C, Biadul N, Lertsithichai P. Idiopathic granulomatous mastitis: A retrospective cohort study between 44 patients with different treatment modalities. Annals of medicine and surgery. 2018 Dec 1;36:162-7.
Pluguez-Turull CW, Nanyes JE, Quintero CJ, Alizai H, Mais DD, Kist KA, Dornbluth NC. Idiopathic granulomatous mastitis: Manifestations at multimodality imaging and pitfalls. Radiographics. 2018 Mar 12;38(2):330-56.
Mahmodlou R, Dadkhah N, Abbasi F, Nasiri J, Valizadeh R. Idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment. Electronic physician. 2017 Sep;9(9):5375.
Elzahaby IA, Khater A, Fathi A, Hany I, Abdelkhalek M, Gaballah K, Elalfy A, Hamdy O. Etiologic revelation and outcome of the surgical management of idiopathic granulomatous mastitis; An Egyptian centre experience. Breast disease. 2016 Jan 1;36(4):115-22.
Co M, Cheng VC, Wei J, Wong SC, Chan SM, Shek T, Kwong A. Idiopathic granulomatous mastitis: a 10-year study from a multicentre clinical database. Pathology. 2018 Dec 1;50(7):742-7.
Hasbahceci M, Kadioglu H. Use of Imaging for the Diagnosis of Idiopathic Granulomatous Mastitis: A Clinician's Perspective. Journal of the College of Physicians and Surgeons Pakistan. 2018 Nov 1;28(11):862-7.
Touny A, El Gemeie E, Gouda I. Recurrent Idiopathic Granulomatous Mastitis: A Clinico-Pathological Study with Evaluation of Combined Surgical Excision and Methotrexate Therapy. Kasr El Aini Journal of Surgery. 2008 Sep;9(3):55.
Lacambra M, Thai TA, Lam CC, Alex MC, Pham HT, Law BK, Van Nguyen T, Pham DX, Gary MT. Granulomatous mastitis: the histological differentials. Journal of clinical pathology. 2011 May 1;64(5):405-11.
Gurleyik G, Aktekin A, Aker F, Karagulle H, Saglamc A. Medical and surgical treatment of idiopathic granulomatous lobular mastitis: a benign inflammatory disease mimicking invasive carcinoma. Journal of breast cancer. 2012 Mar 1;15(1):119-23.
Patil S, Chitnis A, Kandalkar R, Yadav P, Pranay I. An unusual case of Granulomatous mastitis in male patient. Journal of Evolution of Medical and Dental Sciences. 2015 Jul 27;4(60):10562-4.
Yılmaz TU, Gürel B, Güler SA, Baran MA, Erşan B, Duman S, Utkan Z. Scoring Idiopathic Granulomatous Mastitis: An Effective System for Predicting Recurrence?. European journal of breast health. 2018 Apr;14(2):112.
Akcan A, Akyıldız H, Deneme MA, Akgun H, Arıtas Y. Granulomatous lobular mastitis: a complex diagnostic and therapeutic problem. World journal of surgery. 2006 Aug 1;30(8):1403-9.
Omranipour R, Mohammadi SF, Samimi P. Idiopathic granulomatous lobular mastitis-report of 43 cases from Iran; introducing a preliminary clinical practice guideline. Breast Care. 2013;8(6):439-43.
Yabanoğlu H, Çolakoğlu T, Belli S, Aytac HO, Bolat FA, Pourbagher A, Tezcaner T, Yildirim S, Haberal M. A comparative study of conservative versus surgical treatment protocols for 77 patients with idiopathic granulomatous mastitis. The breast journal. 2015 Jul;21(4):363-9.
Akcan A, Öz AB, Dogan S, Akgün H, Akyüz M, Ok E, Gök M, Talih T. Idiopathic granulomatous mastitis: comparison of wide local excision with or without corticosteroid therapy. Breast Care. 2014;9(2):111-.
Bani-Hani KE, Yaghan RJ, Matalka II, Shatnawi NJ. Idiopathic granulomatous mastitis: time to avoid unnecessary mastectomies. The breast journal. 2004 Jul;10(4):318-22.
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