Treatment Modality of Idiopathic Granulomatous Mastitis with Surgery Alone or in Combination with Steroid

2021 ◽  
Vol 7 (1) ◽  
pp. 924-926
Author(s):  
Nilufar Shabnam ◽  
Md Iqbal Mahmud Choudhury ◽  
Tazin Ahsan
Keyword(s):  
Wide Spectrum ◽  
Surgical Excision ◽  
Disease Diagnosis ◽  
Chronic Inflammatory Disease ◽  
Fistula Formation ◽  
Controlled Clinical Trial ◽  
Granulomatous Mastitis ◽  
Inflammatory Mass ◽  
Idiopathic Granulomatous Mastitis ◽  
Therapeutic Modalities

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)

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
Keyword(s):  
Recurrence Rate ◽  
Low Dose ◽  
Unknown Origin ◽  
Surgical Excision ◽  
Chronic Inflammatory Disease ◽  
High Dose ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Results Of Treatment ◽  
Information Treatment

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.

scholarly journals Idiopathic Granulomatous Mastitis Presented with Reactive Arthritis and Erythema Nodosum: Case Report from Iraq

2021 ◽  
Author(s):  
Faiq I. Gorial ◽  
Farah J.
Keyword(s):  
Case Report ◽  
Inflammatory Disease ◽  
Reactive Arthritis ◽  
Erythema Nodosum ◽  
Chronic Inflammatory Disease ◽  
Granulomatous Mastitis ◽  
Inflammatory Mass ◽  
Idiopathic Granulomatous Mastitis

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.

scholarly journals Idiopathic Granulomatous Mastitis Presented with Reactive Arthritis and Erythema Nodosum: Case Report from Iraqi

2021 ◽  
Vol 1 ◽  
pp. 50-52
Author(s):  
Faiq Gorial ◽  
Farah Mahdi
Keyword(s):  
Case Report ◽  
Inflammatory Disease ◽  
Reactive Arthritis ◽  
Erythema Nodosum ◽  
Chronic Inflammatory Disease ◽  
Granulomatous Mastitis ◽  
Inflammatory Mass ◽  
Idiopathic Granulomatous Mastitis

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.

scholarly journals Idiopathic Granulomatous Mastitis Presented with Reactive Arthritis and Erythema Nodosum: Case Report  from Iraqi

2021 ◽  
Author(s):  
Faiq I. Gorial ◽  
Farah J.
Keyword(s):  
Case Report ◽  
Inflammatory Disease ◽  
Reactive Arthritis ◽  
Erythema Nodosum ◽  
Chronic Inflammatory Disease ◽  
Granulomatous Mastitis ◽  
Inflammatory Mass ◽  
Idiopathic Granulomatous Mastitis

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.

scholarly journals Out Come of Wide Local Excision with and without Corticosteroid Therapy in Management of Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 107 (1_suppl) ◽  
pp. 13-13
Author(s):  
R Amira Maher ◽  
Ahmed Gamal Eldin Osman ◽  
K Fahmy ◽  
Shinamwi M ◽  
Osama Al Atarash
Keyword(s):  
Recurrence Rate ◽  
Corticosteroid Therapy ◽  
Surgical Excision ◽  
Cosmetic Outcome ◽  
Systemic Steroid ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Palpable Mass ◽  
Group A ◽  
Group B

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.

scholarly journals Granulomatous Mastitis: A Rare Cause of Male Breast Lump

2016 ◽  
Vol 9 (2) ◽  
pp. 516-519 ◽  
Author(s):  
Abdel Rahman A. Al Manasra ◽  
Mohammad F. Al-Hurani
Keyword(s):  
Breast Tissue ◽  
Nipple Discharge ◽  
Surgical Excision ◽  
Male Breast ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Radiologic Findings ◽  
Female Breast ◽  
The Right ◽  
Histopathologic Findings

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.

scholarly journals Idiopathic granulomatous mastitis with erythema nodosum and polyarthritis

Reumatismo ◽  
2016 ◽  
Vol 68 (2) ◽  
pp. 97 ◽  
Author(s):  
J. Alungal ◽  
M.C. Abdulla ◽  
R. Narayan
Keyword(s):  
Erythema Nodosum ◽  
Oral Prednisolone ◽  
Needle Aspiration ◽  
Left Breast ◽  
Chronic Inflammatory Disease ◽  
Granulomatous Mastitis ◽  
Aspiration Cytology ◽  
Idiopathic Granulomatous Mastitis ◽  
Painful Mass ◽  
Needle Aspiration Cytology

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.

scholarly journals Idiopathic granulomatous mastitis

2011 ◽  
Vol 15 (1) ◽  
pp. 4
Author(s):  
Grace Rubin ◽  
Debra Ardath Meerkotter
Keyword(s):  
Breast Carcinoma ◽  
Medical Treatment ◽  
Immunosuppressive Therapy ◽  
Core Biopsy ◽  
Fungal Infections ◽  
Rare Condition ◽  
Surgical Excision ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Ultrasound Features

The rare condition of idiopathic granulomatous mastitis (IGM) is presented here, unusually, in a 54-year-old woman. IGM mimics breast carcinoma and further differentials include tuberculosis and fungal infections of the breast together with other chronic granulomatous conditions. Of note is its characteristic ultrasound features that can suggest the diagnosis. Diagnosis is made by core biopsy and histology. Patients have been shown to respond to steroid and other immunosuppressive therapy, with surgical excision reserved for those whose condition is recurrent and unresponsive to medical treatment.

scholarly journals Granulomatous mastitis-a challenging surgical entity

2017 ◽  
Vol 4 (6) ◽  
pp. 2077 ◽  
Author(s):  
Thrishuli P. B. ◽  
Akshata Kamath B.
Keyword(s):  
Breast Disease ◽  
Needle Aspiration ◽  
Chronic Inflammatory Disease ◽  
Wide Excision ◽  
Reproductive Age ◽  
Excision Biopsy ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Short Course ◽  
Needle Aspiration Cytology

Background: Idiopathic granulomatous mastitis is a rare benign breast disease, first described by Kessler and Wolloch in 1972. It is characterized by chronic necrotizing granulomatous lobulitis of unknown aetiology. The objective of the study is to find out the clinical and management profile of granulomatous mastitis (GM). This study was carried out at JSS hospital, Mysore, Karnataka, India during the period 2014-2016.Methods: Histopathologically diagnosed cases of GM were studied. Data included, detailed history, examination, clinical diagnosis, ultrasound, mammogram and fine needle aspiration cytology (FNAC). All patients were followed for a period of 6 months. Recurrent cases were managed by wide excision and followed for another period of 6 months.Results: 8 patients who were hisptopathologically diagnosed to have granulomatous mastitis were studied. The mean age was found to be 43.5 years. All patients presented with a painless breast lump and were unilateral. The incidence of the same was found to be higher (3.7%) compared to other large volume studies. The best treatment modality with least recurrence in 4 cases was wide local excision and 1 case of quandrantectomy.Conclusions: GM is an uncommon chronic inflammatory disease of the breast. Usually involving a single non-lactating breast in reproductive age group. It clinically mimics tuberculosis and carcinoma. Mammography remains non-conclusive. Excision and wide excision biopsy are both diagnostic and therapeutic in majority of cases. Treatment includes short course of steroids and antibiotic along with close regular surveillance.

scholarly journals Pituitary Adenoma and Hyperprolactinemia Accompanied by Idiopathic Granulomatous Mastitis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Sebahattin Destek ◽  
Vahit Onur Gul ◽  
Serkan Ahioglu ◽  
Kursat Rahmi Serin
Keyword(s):  
Oral Contraceptive ◽  
Contraceptive Use ◽  
Left Breast ◽  
Chronic Inflammatory Disease ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Oral Contraceptive Use ◽  
Lesion Core ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of the breast, and its etiology remains not fully elucidated. IGM is observed more often in patients with autoimmune disease. Hyperprolactinemia is observed during pregnancy, lactation, and a history of oral contraceptive use. A 39-year-old patient with no history of oral contraceptive use presented with complaints such as redness, pain, and swelling in her left breast. Ultrasound and magnetic resonance imaging (MRI) revealed a suspicious inflamed mass lesion. Core biopsy was performed to exclude breast cancer and to further diagnose. The breast abscess was drained and steroids were given for treatment. In order to monitor any progression during the three months of treatment, hormone levels were routinely examined. Prolactin level was above the reference range, and pituitary MRI revealed a pituitary prolactinoma. After treatment with prolactin inhibitors, IGM also improved with hyperprolactinemia. This report emphasizes attention to hyperprolactinemia in cases of IGM diagnosis and treatment.

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