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Background Idiopathic granulomatous mastitis (IGM) is challenging as it is a rare disease with unknown etiology, risk factors difficult to establish, and controversies regarding its treatment. Here we describe demographic and clinical characteristics of patients with IGM diagnosed at a cancer referral center, as well as the microbial isolates and treatment. Methods We reviewed the clinical charts of patients with IGM, diagnosed from 2004 to 2019. Males were excluded. Demographic data, past medical history, signs and symptoms, clinical examination findings, radiological and microbiological results, and treatments were retrieved. Frequencies were calculated for qualitative variables and measures of central tendency and dispersion for quantitative variables. Association between categorical variables was explored with a logistic regression to identify risk factors associated with treatment response. Results Two hundred cases of IGM, with a median age of 38 years, were reviewed. Concerning past medical history data, 66 patients (33.8%) were obese; 45 (30.4%) had used hormonal therapy; 6 (3.4%) had an autoimmune disease; 158 (89.8%) had been pregnant and 100 (77.5%) had breastfed. The most common signs were skin induration (65%), a delimited mass (64.5%), and suppuration (52%). On imaging findings, 53.8% was suspicious for malignancy. Culture was performed on 88 patients (44%), 32 had a microorganism isolated, most commonly Staphylococcus spp. (n=16; 51.6%) and Corynebacterium spp. (n=7; 22.6%). The most common treatment was an antibiotic regimen (n=84, 42%). Improvement was noted with the first-line therapy in 92 patients (46%). Fourteen patients (7%) had persistent symptoms and 46 (23%), relapsed. The presence of fever (OR 11.94; CI95% 1.33-106.80; p=0.027) or induration (OR 2.78; CI95% 1.25-6.19; p=0.012) were associated with a poor response. Conclusion We describe one of the largest IGM series in Latin America, on a population similar to those from other resource-limited countries. Fever and induration were associated to a greater risk of failure to initial treatment. The isolation of Corynebacterium spp. has also been described in other series. The variation of initial therapeutic strategies is an opportunity to standardize treatment by the means of prospective studies. Disclosures All Authors: No reported disclosures.

BackgroundBreast surgery is considered a clean surgery; however, surgical site infection (SSI) rates are higher than predicted. Postoperative drains remain in situ for several days with an inevitable bacterial colonization and increased risk of SSI.MethodsWe conducted a randomized controlled trial from October 2016 to January 2018 in a Mexican cancer center with high SSI prevalence. We included women with elective breast cancer surgery. Patients were randomized to control (standard drain care) or intervention (occlusive dressing with chlorhexidine 2% at the drain exit site). Perioperative management was standardized for both groups. Patient follow-ups were performed on a weekly basis for at least 30 days. Fluid cultures were performed at the first and second week as standardized in the laboratory. At the time of drain removal, the inner portion was sectioned and cultured by Maki’s semi-quantitative technique. Bacterial quantification was performed using 16 s rRNA-qPCR assay. Culture results of drain fluid and tubing were compared between groups.ResultsWe included 104 patients with 167 surgical drains. Patients’ clinical characteristics (i.e., age, body mass index, comorbidities, clinical stage, preoperative risk, neoadjuvant therapy) were similar in both groups, with no statistical differences. Bulb fluid cultures at the first postoperative week were positive in 42.9% of the control group compared with 27.6% of the antiseptic group (P = 0.04). Cultures from the second week assessment were positive in 79.4% of the control group vs. 53.5% of the antiseptic arm (P = 0.001). Cultures from drain-tubes were positive in 70.2 and 43.8% (P = 0.001) of the control and antiseptic group, respectively (Figure 1). Eleven patients developed an SSI, three (15.4%) from the intervention group, and eight (15.8%) from the control group (P = 0.11). Eighty-four pathogens were isolated from the control group samples at week 1 vs. 52 from the intervention group. Staphylococci spp. were the most common microorganisms in Week 1, 61.9% control and 35% intervention group.ConclusionLocal antiseptics provide an opportunity to test simple, safe, and low-cost interventions that may reduce drain bacterial colonization after breast surgery and potentially decrease infectious complications. Our microbiology findings question breast tissue sterility. Disclosures F. Rivera-Buendía, 3M: Donated the dressings used, Research support. D. Vilar-Compte, 3M: Donated the dressings used, Research support.