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Dilaveri C, Degnim A, Lee C, DeSimone D, Moldoveanu D, Ghosh K. Idiopathic Granulomatous Mastitis. Breast J 2024; 2024:6693720. [PMID: 38304866 PMCID: PMC10834090 DOI: 10.1155/2024/6693720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/06/2023] [Accepted: 01/09/2024] [Indexed: 02/03/2024]
Abstract
Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory disorder of the breast that is often underrecognized. The exact etiology and pathophysiology are unknown, but milk stasis is felt to play a role. Classically, this condition is noninfectious, but many cases are noted to be associated with Corynebacterium species. Most patients affected are parous women with a mean age of 35, and many have breastfed within five years of diagnosis. Patients typically present with a painful mass and symptoms of inflammation, and these features can sometimes mimic breast cancer. Biopsy is needed to make a definitive diagnosis, and noncaseating granulomas are found on core biopsy. Many patients have a waxing and waning course over a period of six months to two years. Goal of treatment is to avoid surgery given poor wound healing, high risk of recurrence, and poor cosmetic outcomes. Medical treatment is preferred and includes observation, antibiotics, steroids, and immune modulators such as methotrexate. In more recent years, topical and intralesional steroids have become the treatment of choice, with similar outcomes to oral steroids.
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Affiliation(s)
- Christina Dilaveri
- Mayo Clinic, Department of Medicine, Division of General Internal Medicine, Rochester, USA
| | - Amy Degnim
- Mayo Clinic, Department of Surgery, Division of Breast and Melanoma Surgical Oncology, Rochester, USA
| | - Christine Lee
- Mayo Clinic, Department of Radiology, Division of Breast Imaging and Intervention, Rochester, USA
| | - Daniel DeSimone
- Mayo Clinic, Department of Medicine, Division of Infectious Diseases, Rochester, USA
| | - Dan Moldoveanu
- Mayo Clinic, Department of Surgery, Division of Breast and Melanoma Surgical Oncology, Rochester, USA
| | - Karthik Ghosh
- Mayo Clinic, Department of Medicine, Division of General Internal Medicine, Rochester, USA
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Jiao Y, Chang K, Jiang Y, Zhang J. Identification of periductal mastitis and granulomatous lobular mastitis: a literature review. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:158. [PMID: 36846004 PMCID: PMC9951018 DOI: 10.21037/atm-22-6473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/13/2023] [Indexed: 02/07/2023]
Abstract
Background and Objective Non-puerperal mastitis (NPM) is a breast disease with poor clinical manifestations, which seriously affects women's health and quality of life. Due to the low incidence rate of the disease and the paucity of related research, there is much misdiagnosis and mis-management of periductal mastitis (PDM) and granulomatous lobular mastitis (GLM). Therefore, understanding the differences between PDM and GLM, in terms of etiology and clinical manifestations, is crucial for patient treatment and prognosis. At the same time, choosing different treatment methods may not achieve the best treatment effect, so the appropriate treatment method can often reduce the patient's pain and reduce the recurrence of the patient's disease. Methods The PubMed database was searched for articles published from 1 January 1990 to 16 June 2022 using the following search terms: "non-puerperal mastitis", "periductal mastitis", "granulomatous lobular mastitis", "mammary duct ectasia", "idiopathic granulomatous mastitis", "plasma cell mastitis", and "identification". The key findings of the related literatures were analyzed and summarized. Key Content and Findings We systematically described the key points in the differential diagnosis, treatment, and prognosis of PDM and GLM. The use of different animal models for research and novel drugs to treat the disease were also described in this paper. Conclusions The key points in the differentiation of the two diseases are clearly explained, and the respective treatment options and prognosis are summarized.
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Affiliation(s)
- Yangchi Jiao
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Kexin Chang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yue Jiang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Juliang Zhang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
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Ong SS, Xu J, Sim CK, Khng AJ, Ho PJ, Kwan PKW, Ravikrishnan A, Tan KTB, Tan QT, Tan EY, Tan SM, Putti TC, Lim SH, Tang ELS, Nagarajan N, Karnani N, Li J, Hartman M. Profiling Microbial Communities in Idiopathic Granulomatous Mastitis. Int J Mol Sci 2023; 24:ijms24021042. [PMID: 36674562 PMCID: PMC9863225 DOI: 10.3390/ijms24021042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/27/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
Idiopathic granulomatous mastitis (IGM) is a rare and benign inflammatory breast disease with ambiguous aetiology. Contrastingly, lactational mastitis (LM) is commonly diagnosed in breastfeeding women. To investigate IGM aetiology, we profiled the microbial flora of pus and skin in patients with IGM and LM. A total of 26 patients with IGM and 6 patients with LM were included in the study. The 16S rRNA sequencing libraries were constructed from 16S rRNA gene amplified from total DNA extracted from pus and skin swabs in patients with IGM and LM controls. Constructed libraries were multiplexed and paired-end sequenced on HiSeq4000. Metagenomic analysis was conducted using modified microbiome abundance analysis suite customised R-resource for paired pus and skin samples. Microbiome multivariable association analyses were performed using linear models. A total of 21 IGM and 3 LM paired pus and skin samples underwent metagenomic analysis. Bray−Curtis ecological dissimilarity distance showed dissimilarity across four sample types (IGM pus, IGM skin, LM pus, and LM skin; PERMANOVA, p < 0.001). No characteristic dominant genus was observed across the IGM samples. The IGM pus samples were more diverse than corresponding IGM skin samples (Shannon and Simpson index; Wilcoxon paired signed-rank tests, p = 0.022 and p = 0.07). Corynebacterium kroppenstedtii, reportedly associated with IGM in the literature, was higher in IGM pus samples than paired skin samples (Wilcoxon, p = 0.022). Three other species and nineteen genera were statistically significant in paired IGM pus−skin comparison after antibiotic treatment adjustment and multiple comparisons correction. Microbial profiles are unique between patients with IGM and LM. Inter-patient variability and polymicrobial IGM pus samples cannot implicate specific genus or species as an infectious cause for IGM.
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Affiliation(s)
- Seeu Si Ong
- Women’s Health and Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore 138672, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Jia Xu
- Human Development, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
| | - Choon Kiat Sim
- Human Development, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
| | - Alexis Jiaying Khng
- Women’s Health and Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore 138672, Singapore
| | - Peh Joo Ho
- Women’s Health and Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore 138672, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Saw Swee Hock, School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Philip Kam Weng Kwan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Aarthi Ravikrishnan
- Metagenomic Technologies and Microbial Systems, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore 138672, Singapore
| | - Kiat-Tee Benita Tan
- Division of Surgical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore
- Department of Breast Surgery, Singapore General Hospital, Singapore 169608, Singapore
- Department of General Surgery, Sengkang General Hospital, Singapore 544886, Singapore
| | - Qing Ting Tan
- KK Breast Department, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
| | - Ern Yu Tan
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Institute of Molecular and Cell Biology, Agency for Science, Technology and Research, Singapore 138673, Singapore
| | - Su-Ming Tan
- Division of Breast Surgery, Changi General Hospital, Singapore 529889, Singapore
| | - Thomas Choudary Putti
- Department of Pathology, National University Health System, Singapore 119228, Singapore
| | - Swee Ho Lim
- KK Breast Department, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
| | - Ee Ling Serene Tang
- Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
- Department of Surgery, Woodlands Health Campus, Singapore 768024, Singapore
| | - Niranjan Nagarajan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Metagenomic Technologies and Microbial Systems, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore 138672, Singapore
| | - Neerja Karnani
- Human Development, Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore 117609, Singapore
- Data Hub Division, Bioinformatics Institute, Agency for Science, Technology and Research, Singapore 138671, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Jingmei Li
- Women’s Health and Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore 138672, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Correspondence: ; Tel.: +(65)-6808-8312
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Saw Swee Hock, School of Public Health, National University of Singapore, Singapore 117549, Singapore
- Department of Surgery, University Surgical Cluster, National University Health System, Singapore 119228, Singapore
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Kafadar MT, Bahadır MV, Girgin S. Low-Dose Methotrexate Use in Idiopathic Granulomatous Mastitis: An Alternative Treatment Method. Breast Care (Basel) 2021; 16:402-407. [PMID: 34602947 DOI: 10.1159/000513879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/18/2020] [Indexed: 01/20/2023] Open
Abstract
Background Idiopathic granulomatous mastitis (IGM) is a rare, recurrent and progressive breast disease with an unknown etiology. Patients with IGM will probably face stressful, time-consuming treatment procedures with side effects due to medications. There are different treatment modalities in clinical use including medical and surgical interventions. Objective The aim of this study was to present the results of using the combination therapy of low-dose methotrexate (MTX) and steroid in IGM. Methods Seventeen patients diagnosed with IGM and treated with MTX were included into the study. Low-dose MTX at 5 mg/week and 8 mg/day prednisone were given for 2-3 months. Results After 2-3 months of treatment, 10 patients exhibited (58.5%) complete, 3 patients (17.6%) partial recovery, and no response to the treatment process was observed in 4 patients (23.5%). No side effects of MTX and recurrent events were noted in any of the patients. Conclusion Low-dose MTX and prednisone treatment for IGM patients, who did not respond to steroids alone, should be considered as an alternative treatment method instead of surgical intervention.
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Affiliation(s)
- Mehmet Tolga Kafadar
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Mehmet Veysi Bahadır
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Sadullah Girgin
- Department of General Surgery, Dicle University School of Medicine, Diyarbakır, Turkey
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Alsaleh N. Assertive clinical practice in managing patients with idiopathic granulomatous mastitis: Review of literature. Ann Med Surg (Lond) 2021; 70:102792. [PMID: 34691410 PMCID: PMC8519765 DOI: 10.1016/j.amsu.2021.102792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/24/2021] [Accepted: 09/02/2021] [Indexed: 12/19/2022] Open
Abstract
Idiopathic granulomatous mastitis (IGM) is a benign persistent inflammatory breast entity characterized histologically by lobulo centric granulomas. Diagnosis may be difficult and involves a strong index of suspicion. There are plentiful studies are published which render the disease more frequently than expected. The strategy for imaging IGM depends on patient age, clinical manifestations, and risk factors. Patients have an excellent prognosis when they are appropriately treated. The management remains contentious, good judgment is required to ensure optimum treatment form and timing.
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Affiliation(s)
- Nuha Alsaleh
- Division of General Surgery, Department of Surgery, College of Medicine and King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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Ma X, Min X, Yao C. Different Treatments for Granulomatous Lobular Mastitis: A Systematic Review and Meta-Analysis. Breast Care (Basel) 2020; 15:60-66. [PMID: 32231499 PMCID: PMC7098302 DOI: 10.1159/000501498] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 06/14/2019] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Granulomatous lobular mastitis (GLM) is infrequently diagnosed. This study aimed to evaluate the efficacy and safety of managements for GLM in the nonlactation period. METHODS Publications were retrieved from PubMed, EMBASE, and the Cochrane library on September 10, 2018. We pooled and compared the outcome parameters and complete remission (CR) rates between different treatments using a meta-analysis. RESULTS Twenty-one publications including 970 patients treated with surgical excision, steroids, abscess drainage, antibiotics, and observation were included. Surgery significantly improved CR rate compared with steroids (p = 0.0003). There was no difference in the CR rate in patients treated with surgery alone or combined with steroids (p = 0.28). Surgery showed borderline significant efficacy in the CR rate compared with antibiotics (p = 0.06) and abscess drainage (p = 0.06). No difference was observed in effectiveness between observation and surgical management in patients diagnosed with early GLM and mild symptoms. CONCLUSIONS Although surgery was the ideal management for GLM, steroids and antibiotics might be ideal managements for GLM patients who are worried about surgical scars. Observation was an impressive alternative for patients with early GLM.
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Affiliation(s)
- Xiaojia Ma
- Nanjing University of Chinese Medicine, Nanjing, China
- Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| | - Xiaoli Min
- Department of Cerebrovascular Diseases, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chang Yao
- The First Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Granulomatous Mastitis and Factors Associated with Recurrence: An 11-Year Single-Centre Study of 113 Patients in Singapore. World J Surg 2019; 43:1737-1745. [PMID: 31049604 DOI: 10.1007/s00268-019-05014-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Granulomatous mastitis (GM) is an inflammatory breast disease of unknown aetiology. It poses diagnostic and therapeutic challenges with myriad forms of clinical presentation, varying results to treatments and propensity to recur. This study aims to look at clinical and treatment factors that predispose to recurrence of GM. METHODS We performed a retrospective review of 113 patients in our unit with histologically proven GM from 2006 to 2016. Demographic, clinical, treatment and outcomes data were collected and analysed. RESULTS Eighty-nine patients were treated with antibiotics (78.8%), 79 (69.9%) with steroids and 23 (20.4%) patients underwent surgery. Twenty (17.7%) patients had recurrence. Patients who presented with inflammatory signs and symptoms had increased odds of having subsequent recurrence: skin changes (1.50), pain (2.00), fistula (4.39) and antibiotic treatment (6.65). Four patients (20%) with recurrence had positive bacterial cultures. All 4 grew Corynebacterium. Patients with Corynebacterium infection had a 2.64 times higher risk of recurrence. Surgery did not preclude recurrence. There was a 70% (7/10) penicillin resistance rate in our patients with positive cultures for Corynebacterium. CONCLUSION Initial presentation with inflammatory signs and symptoms may confer increased risk of recurrence, warranting closer monitoring. Corynebacterium infection may play a part as a causative factor and risk factor for recurrence. Non-penicillin antibiotics should be considered as first-line antibiotics for patients presenting with inflammatory changes. Further prospective studies with larger patient populations might reveal information on the aetiology of GM and result in the development of a more standardized and effective treatment regimen.
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Davis J, Cocco D, Matz S, Hsu CH, Brown MJ, Lee J, Bouton ME, Caruso DM, Komenaka IK. Re-evaluating if observation continues to be the best management of idiopathic granulomatous mastitis. Surgery 2019; 166:1176-1180. [PMID: 31400951 DOI: 10.1016/j.surg.2019.06.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/03/2019] [Accepted: 06/10/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND The presentation of idiopathic granulomatous mastitis can mimic breast cancer. Therefore, awareness of the condition is important for surgeons. The current series is the largest in a US population. METHODS Retrospective chart review of patients treated at a county, safety-net hospital in Arizona. Cases were identified from January 2006 to January 2019. Sociodemographic information, clinical history, management, and outcomes were collected. RESULTS There were 145 occurrences of idiopathic granulomatous mastitis among 120 women. Most of the patients (92%) were of Hispanic ethnicity and born outside (87%) of the United States. The average age was 35 years. Nearly all patients (95%) were parous, with an average of 3 pregnancies. Most (88%) presented with a palpable mass, and more than half (54%) of these masses were painful. Six patients had prolactinomas or hyperprolactinemia, 11 patients were pregnant, and 5 were postpartum. Early in the time period studied, 6 patients underwent excision of the masses. The remaining 114 underwent planned observation after biopsy confirmation of the diagnosis. Two patients were lost to follow-up, and the other 112 patients with idiopathic granulomatous mastitis resolved spontaneously. Nineteen had more than 1 episode. Average time to resolution was 5 months (range 0-20). Adjusted log-normal regression analysis found that later age of first live birth was associated with greater time to resolution (P < .01). CONCLUSION Idiopathic granulomatous mastitis is a self-limited, benign condition that waxes and wanes and eventually resolves without resection. After diagnosis, medications are unnecessary, and operations can be limited to drainage procedures for fluid collections.
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Affiliation(s)
- John Davis
- Department of Surgery, Maricopa Medical Center, Phoenix, AZ
| | - Daniela Cocco
- Department of Surgery, Maricopa Medical Center, Phoenix, AZ
| | - Samantha Matz
- Department of Radiology, Maricopa Medical Center, Phoenix, AZ
| | - Chiu-Hsieh Hsu
- Arizona Cancer Center, University of Arizona, Tucson, AZ; Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, AZ
| | - Morgan J Brown
- Department of Pathology, Maricopa Medical Center, Phoenix, AZ
| | - Jennifer Lee
- Department of Surgery, Arizona State University, Phoenix, AZ
| | | | | | - Ian K Komenaka
- Department of Surgery, Maricopa Medical Center, Phoenix, AZ; Arizona Cancer Center, University of Arizona, Tucson, AZ.
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Liu L, Zhou F, Zhang X, Liu S, Liu L, Xiang Y, Guo M, Yu L, Wang F, Ma Z, Li L, Gao D, Zhang Q, Fu Q, Yu Z. Granulomatous Lobular Mastitis: Antituberculous Treatment and Outcome in 22 Patients. Breast Care (Basel) 2018; 13:359-363. [PMID: 30498422 DOI: 10.1159/000487935] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Granulomatous lobular mastitis (GLM) is a rare chronic inflammatory condition of the breast. The purpose of this study was to describe antituberculous treatment of GLM and the long-term follow-up outcome. Methods This retrospective study included 22 patients who had been histopathologically diagnosed with GLM at the Second Hospital of Shandong University from January 2011 to March 2015. Clinical characteristics, ultrasonography and mammography findings, laboratory tests, treatment regimens, follow-up information, and recurrences were recorded. Results All patients were female with a median age of 29 (range 23-44) years. The most common symptom was a breast mass with or without pain. Large irregular hypoechoic masses could be found in the breast ultrasounds of 13 patients. All patients received triple antituberculous therapy. During a median follow-up period of 40 months, 3 patients were lost to follow-up; of the remaining 19 patients, 18 achieved clinical complete remission and no recurrences were observed. Conclusion GLM is an unusual benign breast condition that mimics breast carcinoma in its clinical and imaging presentation. Antituberculous therapy seems to be an effective alternative option in the treatment of GLM.
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Affiliation(s)
- Lu Liu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Department of Breast Surgery, Qingdao Municipal Hospital Group, Qingdao, Shandong, China
| | - Fei Zhou
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Xiaoxia Zhang
- Department of Thyroid and Breast Surgery, Linyi People's Hospital, Linyi, Shandong, China
| | - Shuchen Liu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Liyuan Liu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Yujuan Xiang
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Mingming Guo
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Lixiang Yu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Fei Wang
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Zhongbing Ma
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Liang Li
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Dezong Gao
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Qiang Zhang
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Qinye Fu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
| | - Zhigang Yu
- Department of Breast Surgery, The Second Hospital of Shandong University, Jinan, Shandong, China.,Institute of Translational Medicine of Breast Disease Prevention and Treatment, Shandong University, Jinan, Shandong, China
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Moris D, Damaskos C, Davakis S, Vailas M, Garmpis N, Spartalis E, Kontos M, Kontzoglou K. Is idiopathic granulomatous mastitis a surgical disease? The jury is still out. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:309. [PMID: 28856149 DOI: 10.21037/atm.2017.05.24] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Idiopathic granulomatous mastitis (IGM), is a rare entity of chronic inflammatory disorder of the breast of unknown etiology. Very few cases have been described so far, almost exclusively in women. Here we describe a case of IGM in a 53-year-old man presented with a right breast mass, progressively enlarging during the last 6 months. Due to the findings of clinical examination and CT-scan, the suspicion for a potentially malignant lesion was given and the decision for surgical resection was made. Microscopic analysis of the specimen showed non-caseating granulomas around mammary lobules, findings compatible with IGM. The patient is recurrence-free at 18-month follow-up. IGM is a rare benign inflammatory breast disease, usually seen in females of reproductive age. Establishing a diagnosis can be challenging for a surgeon and requires a high index of suspicion as most patients are initially misdiagnosed by their primary care physicians. Steroids and immunosuppressive drugs are considered as fundamental treatment modalities but they are correlated with increased rates of disease response and recurrence. On the contrary, surgical resection demonstrated significantly superior results compared to steroid-alone treatment in terms of recurrence and post-treatment recovery.
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Affiliation(s)
- Demetrios Moris
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Davakis
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Michail Vailas
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Garmpis
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleftherios Spartalis
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Kontos
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Uysal E, Soran A, Sezgin E. Factors related to recurrence of idiopathic granulomatous mastitis: what do we learn from a multicentre study? ANZ J Surg 2017; 88:635-639. [DOI: 10.1111/ans.14115] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/10/2017] [Accepted: 05/20/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Erdal Uysal
- Department of General Surgery; Sanko University School of Medicine; Gaziantep Turkey
| | - Atilla Soran
- Department of Breast Surgery; Magee-Womens Hospital of UPMC; Pittsburgh Pennsylvania USA
| | - Efe Sezgin
- Laboratory of Nutrigenomics and Epidemiology, Department of Food Engineering, İzmir İnstitute of Technology; Izmir Turkey
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