A Challenging Entity in the Differential Diagnosis of Breast Cancer: A Retrospective Analysis of 17 Cases With Granulomatous Lobular Mastitis

Eser, Mehmet; Kaptanoğlu, Levent; Kement, Metin; Eyvaz, Kemal; Gökçeimam, Mehmet; Kurt, Necmi; Demiray, Mukaddes; Geçer, Melin Özgün

doi:10.5152/tjbh.2013.07

Cited by 2 publications

(1 citation statement)

References 36 publications

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“…On the contrary, Western countries like the USA [15], the UK [5], and New Zeeland [20] have a remarkably lower rate of IGM. Our work, as well as that of others [20,28,29], revealed that IGM is usually seen in women who are lactating or those who have been lactating. This finding may explain why IGM is more common in Middle Eastern countries such as Iran, Turkey, and Egypt than in other regions of the world.…”

Section: Discussionsupporting

confidence: 81%

Idiopathic Granulomatous Mastitis: Cytologic and Histologic Study of 65 Egyptian Patients

Helal

Shash²,

El-Din³

et al. 2016

Acta Cytologica

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Background: The etiology of idiopathic granulomatous mastitis (IGM) is unknown, and it is commonly misdiagnosed clinically and/or radiologically as breast cancer. The role of fine-needle aspiration cytology (FNAC) in its diagnosis is still a matter of debate. The aim of the current study is to assess the value of FNAC in the diagnosis of IGM, and to search for the presence of bacteria in IGM with cystic vacuoles, which was described recently by a few authors. Materials and Methods: Retrospective study of cytologic smears and histologic tissue sections of 65 Egyptian IGM cases was done along with microbiologic testing. A comparison of the frequency of IGM in Egypt to that of other populations was also made. Results: IGM has typical FNA features which can easily exclude malignancy. Histologically, cystic vacuoles were encountered in 35 out of 65 cases (53.9%), with only 6 (17.14%) of these cases showing Gram-positive bacilli (GPB). The frequency of IGM in Egypt is comparable to those in other Middle Eastern countries but much higher than in Western countries. Conclusion: IGM is a common breast disease in Egypt. FNAC in IGM has a high diagnostic accuracy. This study supports the few recent studies that have detected GPB in IGM with cystic vacuoles. Thus, bacteriologic examination in such cases may affect the treatment strategy.

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Section: Discussionsupporting

confidence: 81%

Idiopathic Granulomatous Mastitis: Cytologic and Histologic Study of 65 Egyptian Patients

Helal

Shash²,

El-Din³

et al. 2016

Acta Cytologica

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A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention

Ong,

Ho,

Liow

et al. 2024

Front. Med.

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PurposeThe major aim of our meta-analysis was to review the effectiveness of various treatment modalities for achieving successful remission and preventing recurrence for women with idiopathic granulomatous mastitis (IGM). This knowledge is instrumental in developing evidence-based guidelines for clinicians to improve management strategies and outcomes for patients with IGM.MethodsA systematic literature search was performed on MEDLINE (Ovid), Embase (Elsevier), PubMed, Cochrane Library, Web of Science, and Google Scholar; studies published to 19 January 2022 were included. A meta-analysis of 57 observational studies was performed. The results of two randomized controlled trials were also examined.ResultsThere were 3,035 IGM patients across the observational and randomised studies. Overall recurrence and remission rates across all treatment strategies in 59 studies are 87.9% (2,667/3035) and 13.5% (359/2667), respectively. The studies reported 19 different treatment strategies, comprising observation, medical monotherapies, surgery, and combinations involving medical therapies, with and without surgery. Among monotherapy treatment, surgical management had the highest pooled remission rate (0.99 [95% confidence interval (CI) = 0.97–1.00]); among combination therapy, this was steroids and surgery (0.99 [0.94–1.00]). Antibiotic monotherapy had the lowest remission rate (0.72 [0.37–0.96]). The highest recurrence rates belonged to treatments that combined antibiotics and surgery (0.54 [0.02–1.00]), and antibiotics, steroids, and surgery (0.57 [0.00–1.00]). Most successful for preventing recurrence were observation (0.03 [0.00–0.10]), methotrexate (0.08 [0.00–0.24]), and steroids and surgery (0.05 [0.01–0.12]). There is a significant association between longer follow-up duration and recurrence rate reported, p = 0.002.ConclusionCombination therapies, especially those incorporating antibiotics, steroids, and surgery, have demonstrated higher remission rates, challenging the use of antibiotic monotherapy. There is an increased emphasis on the need for personalised, multi-pronged approach for preventing IGM recurrence, with longer follow-up care. More prospective future work in IGM research, with standardised diagnostic criteria, treatment protocols, and reporting guidelines will be important for developing treatment protocols and guidelines clinicians can adhere to in the clinical management of IGM patients.Systematic review registration: PROSPERO (CRD42022301386).

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A Challenging Entity in the Differential Diagnosis of Breast Cancer: A Retrospective Analysis of 17 Cases With Granulomatous Lobular Mastitis

Cited by 2 publications

References 36 publications

Idiopathic Granulomatous Mastitis: Cytologic and Histologic Study of 65 Egyptian Patients

Idiopathic Granulomatous Mastitis: Cytologic and Histologic Study of 65 Egyptian Patients

A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention

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