scholarly journals Idiopathic granulomatous mastitis: challenges of treatment in iranian women

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leyla Shojaee ◽  
Nasrin Rahmani ◽  
Siavash Moradi ◽  
Asieh Motamedi ◽  
Gholamali Godazandeh

Abstract Background and objective As a chronic inflammatory disease of an unknown origin, the treatment of granulomatous mastitis has always been controversial. According to some researchers, surgical treatment and certain medications, especially steroids, are more effective in treating the disease. This study aimed at evaluating the results of treatment in a group of patients with granulomatous mastitis. Materials and methods This longitudinal cohort study evaluated the treatment outcomes of 87 patients with pathology-confirmed granulomatous mastitis referred to the surgical clinic of Central Hospital in Sari, Iran. Demographic, clinical, and pathological information, treatment methods and results, and the recurrence rate were analyzed. Findings A total of 87 female patients with granulomatous mastitis aged 22–52 years with a mean age of 34 years were evaluated. All patients had palpable masses; the breast masses were painful in 48.3% of patients, and 55.2% of patients suffered from erythema and inflammation, and8% had fistulas and ulcers at the inflammation site. The patients were followed-up for an average duration of 26 months (8–48 months) after treatment and recovery. The overall recurrence rate was 24.1%, and the recurrence rate was 29.4% in patients underwent surgery, 34.8% in patients received high-dose prednisolone, and 17% in those received low-dose prednisolone together with drainage (p < 0.001). Conclusions According to the results, the low-dose prednisolone plus drainage was more effective with a lower recurrence rate than only surgical excision or high-dose prednisolone. In fact, the use of minimally invasive methods such as drainage plus low-dose steroids is a more effective method with fewer side effects than the other two methods.

2021 ◽  
Vol 107 (1_suppl) ◽  
pp. 13-13
Author(s):  
R Amira Maher ◽  
Ahmed Gamal Eldin Osman ◽  
K Fahmy ◽  
Shinamwi M ◽  
Osama Al Atarash

Introduction: Idiopathic granulomatous mastitis is a rare benign breast disease. Initial reports from hospitals in Egypt from Departments of Pathology at Cancer Institutes of Cairo, Tanta and Mansoura Universities; indicate that the disease is not as rare as that in the developed countries. It often mimics breast carcinoma both clinically and radiologically. Histological examination is the gold standard for diagnosis. Management of Idiopathic granulomatous mastitis is still debatable. In our study, we aimed to evaluate the addition of corticosteroid therapy to surgical excision in management of idiopathic granulomatous mastitis. Patients and Methods: This is a comparative study was conducted at Ain-Shams University Hospital’s breast clinic on patients with idiopathic granulomatous mastitis from to August 2015 till September 2018. Thirty patients were divided into 2 groups. Group (A) includes patients who underwent surgical management only. Group (B) includes patients who received corticosteroid therapy according to the severity of the cases then surgical Excision was done for the residual lesion. Follow up of all cases up to 1-2 years was done to document the recurrence rate and compare the cosmetic outcome of both groups. Informed consent was obtained from all patients included in the study. Results: The mean age of the affected women was 38.80 and 33.13 in group (A) and group (B), respectively and it wasn’t statistically different (p value = 0.099). The most common presenting symptom was a palpable mass in the breast (66.7% and 93.3%) in group (A) and group (B) respectively. Recurrence rate was higher in group (A) (40%) with no recurrence documented in group (B) however 2 cases were omitted from the study due to steroid noncompliance and complications. Cosmetic outcome was excellent in 76.9% of group (B) and good in 53.3% of group (A). Conclusion: Systemic steroid therapy with surgical resection is the recommended as first-line treatment strategy for IGM as it shows less recurrence rate and surgical scarring. Increased awareness of IGM will increase their understanding and improve their management.


2021 ◽  
Vol 7 (1) ◽  
pp. 924-926
Author(s):  
Nilufar Shabnam ◽  
Md Iqbal Mahmud Choudhury ◽  
Tazin Ahsan

Background: Idiopathic Granulomatous Mastitis (IGM) is a rare chronic inflammatory disease. Diagnosis and treatment is still a challenge because of obscure etiology and rareness. Owing to wide spectrum of IGM it is difficult to standardize and optimize the treatment. The aim of our study was to evaluate the outcome of surgical excision or in combination with steroid in treating IGM. Methodology: A randomized controlled clinical trial was done in BIRDEM (Bangladesh Institute of Research and Rehabilitation of Diabetic, Endocrine and Metabolic Disorder) Hospital, Dhaka, Bangladesh from July’2008 to June’2018. Overall 82 patients met the inclusion criteria. We analyzed therapeutic modalities and compared the patients’ outcomes based on treatment. Results: All patients underwent wide excision with clear margin under general anesthesia. Post operatively steroid was given in 41 patients. Duration of steroid therapy was 6 months after surgery. We have seen that recovery time was short in steroid group (Gr-II) average 167.07 days in compared without steroid (Gr l) average 253.28 days. Patients who underwent surgery only (GR-I) about 49.90% patients experienced recurrence (e.g. fistula formation and inflammatory mass etc.) On the other hand, 12.1% patients developed recurrences that were treated with steroid following surgery (Gr-II). Conclusion: Surgery with steroid is more effective in treatment of idiopathic granulomatous mastitis than surgery alone. Bioresearch Commu. 7(1): 924-926, 2021 (January)


2016 ◽  
Vol 9 (2) ◽  
pp. 516-519 ◽  
Author(s):  
Abdel Rahman A. Al Manasra ◽  
Mohammad F. Al-Hurani

Background: Mastitis is a common benign disorder of the female breast. It is frequently associated with tenderness, swelling and nipple discharge. We are describing an extremely rare case of an idiopathic granulomatous mastitis in the male breast. Only 1 previous case was reported. Case Report: A 29-year-old male patient presented with a hard, painless lump in the right breast of 2 weeks duration. The patient underwent surgical excision with margin. The histopathologic findings were consistent with granulomatous mastitis. The case was reported as idiopathic granulomatous mastitis after exclusion of all known causes of the disease. Conclusion: Granulomatous mastitis is rare in females and extremely rare in male breast tissue. Since this disease mimics breast cancer in its clinical picture and radiologic findings are usually not conclusive, surgical excision is recommended in all cases.


Breast Care ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 415-420
Author(s):  
Fei Zhou ◽  
Lu Liu ◽  
Liyuan Liu ◽  
Lixiang Yu ◽  
Fei Wang ◽  
...  

Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign breast disease without any definitive therapeutic strategy. It is controversial whether to use conservative or surgical treatment of IGM and high-level evidence-based medicine data are lacking. The purpose of this study was to systemically evaluate the clinical effectiveness of the conservative versus surgical treatment for IGM. Methods: In this meta-analysis, we searched PubMed, EMbase, ScienceDirect, and Web of Science for comparative studies about the conservative versus surgical treatment of IGM. Two researchers independently identified reports and extracted data. We used Stata 11 for data analysis. A meta-analysis was performed to investigate the differences in the recurrence rate of conservative and surgical treatment using a random effects model. Results: A total of 10 studies involving 1,101 patients were included. The results demonstrated that there was no significant difference in the recurrence rate among patients who were treated by nonsurgical therapy and surgical treatment. No publication bias was detected. Conclusion: This meta-analysis demonstrates that both the conservative and surgical treatment approaches have appropriate efficacy in IGM treatment and relapse. Further randomized controlled trials with longer follow-up periods are required to confirm the advantages of each approach.


2021 ◽  
Author(s):  
Faiq I. Gorial ◽  
Farah J.

Abstract Idiopathic Granulomatous Mastitis (IGM) is a rare chronic inflammatory disease that involves the development of an inflammatory mass in the breast, which may be difficult to differentiate from malignancy. Few patients have been reported in the literature presenting with arthritis accompanying IGM of breast. Here we report a case of Iraqi patient presented as IGM with reactive arthritis and erythema nodosum.


Breast Care ◽  
2021 ◽  
pp. 1-6
Author(s):  
Mehmet Tolga Kafadar ◽  
Mehmet Veysi Bahadır ◽  
Sadullah Girgin

<b><i>Background:</i></b> 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. <b><i>Objective:</i></b> The aim of this study was to present the results of using the combination therapy of low-dose methotrexate (MTX) and steroid in IGM. <b><i>Methods:</i></b> 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. <b><i>Results:</i></b> 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. <b><i>Conclusion:</i></b> 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.


Reumatismo ◽  
2016 ◽  
Vol 68 (2) ◽  
pp. 97 ◽  
Author(s):  
J. Alungal ◽  
M.C. Abdulla ◽  
R. Narayan

A 25 year-old woman presented with a painful mass in the left breast, polyarthritis and erythema nodosum. Fine needle aspiration cytology led to a diagnosis of granulomatous mastitis. Oral prednisolone rapidly improved the arthritis and the erythema nodosum. Granulomatous mastitis is a very rare, chronic inflammatory disease and only ten patients with granulomatous mastitis with erythema nodosum and polyarthitis have been described.


Author(s):  
Faiq Gorial ◽  
Farah Mahdi

Idiopathic Granulomatous Mastitis (IGM) is a rare chronic inflammatory disease that involves the development of an inflammatory mass in the breast, which may be difficult to differentiate from malignancy. Few patients have been reported in the literature presenting with arthritis accompanying IGM of the breast. Here we report a case of an Iraqi patient who presented as IGM with reactive arthritis and erythema nodosum.


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