Idiopathic granulomatous mastitis: A diagnostic and therapeutic challenge - 15/09/17
Abstract |
Background |
Idiopathic granulomatous mastitis is a rare benign breast disease of women of reproductive age. It usually presents as a painful mass. Since the etiology is unclear, directed diagnosis and management is lacking.
Methods |
This is a retrospective chart review of 14 patients, over twelve years (2004–2016), identified through query of pathology findings.
Results |
Two asymptomatic patients were diagnosed after oncologic breast resection following neoadjuvant chemotherapy. The remaining twelve patients were young (31.7 years, range 23–43 years), predominantly non-white (50% African/African-American, 36% Hispanic, 7% Asian), pregnant within the last five years (86%), with no prior granulomatous disease. Evaluation included breast imaging, microbial cultures and staining, and biopsy. Treatment included antibiotics (57%), corticosteroids (21%), methotrexate (7%), and/or surgery (71%). Imaging suggests segmental masses, possibly abscess.
Conclusion |
Granulomatous mastitis is uncommon, and difficult to diagnose and manage. We review our experience, the literature, and propose an algorithm for diagnosis and management.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Idiopathic granulomatous mastitis (IGM) is challenging to treat since the etiology is unclear. |
• | Those diagnosed with IGM tend to be young, within five years post-partum, and present with a persistent painful mass. |
• | Excision of the mass is successful in halting the process in approximately 85% of the patients. |
• | Corticosteroids may conserve breast tissue in patients with a sterile abscess and no contraindications to immunosuppression. |
Keywords : Granulomatous mastitis, Breast, Management, Treatment, Diagnosis
Abbreviation : IGM, mg, NSAIDS
Plan
Vol 214 - N° 4
P. 701-706 - octobre 2017 Retour au numéro
Article précédent
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