A clinical observation of stage I implant breast reconstruction for mass-like granulomatous lobular mastitis

Abstract

Background: Granulomatous lobular mastitis (GLM) is a chronic benign inflammatory breast disease, and mainly mass-like granulomatous lobular mastitis (MGLM) clinically. There are few reports on applications of stage I implant breast reconstruction in GLM. This observational study was conducted to evaluate the safety and efficacy of stage I implant breast reconstruction in the treatment of MGLM. Methods: Patients suffering from MGLM who visited at hospital from April 2019 to June 2020 were selected and graded according to the magnetic resonance imaging (MRI) examination. Patients with MGLM were grouped into the prosthesis implantation group and the traditional treatment group according to their preferences. Clinical parameters of the two groups were analyzed before and after surgery, such as postoperative infection, recurrence, and satisfaction with appearance and aesthetics were observed. To evaluate the safety and efficacy of the implant breast reconstruction in MGLM.Results: There were 59 cases of MGLM, 31 cases of grade 3-4 GLM, 11 cases of bilateral metachronous GLM. There were 18 patients in the prosthesis implantation group, including 9 patients with bilateral metachronous GLM, 2 patients with synchronous GLM, and 41 patients in the traditional treatment group. All the patients were followed up with a median of 17.5 months. One patient in the observation group had an infection on the reconstructed side 3 weeks after surgery, and the implant was retained after 2 weeks of conservative treatment such as antibiotics. Two patients in the prosthesis implantation group were not satisfied with size of the reconstructed breast was smaller than the opposite side. In the traditional treatment group, there were 3 cases of postoperative infection or delayed wound healing, and 26 cases of postoperative breast asymmetry.Conclusions: For patients with MGLM, it is safe to select stage I prosthesis implantation after conservative treatment, with exact effect and high patient satisfaction.

Plastic and reconstructive breast surgery techniques in the surgical treatment of idiopathic granulomatous mastitis: a single-center experience

“…Otherwise, prolonged excision may leave a large tissue defect that is difficult to close, resulting in a negative cosmetic outcome [ 27 ]. As a result, some authors recommend stage I prosthesis implantation for patients with IGM after conservative treatment for definitive efficacy and high patient satisfaction [ 16 ], or delayed breast reconstruction to monitor surgical recurrence [ 28 ]. We advocate wide excision and reconstruction with simultaneous plastic and reconstructive breast surgery techniques for patients.…”

“…While these techniques allow wide surgical excisions in patients with breast cancer, they also aim to protect the breast. Similarly, many authors have used these new techniques derived from plastic surgery techniques to ensure wide surgical excisions in the surgical management of IGM [ 7 8 14 15 16 ]. Although the term ‘oncoplastic’ in conjunction with the techniques used in the surgical treatment of benign breast disease has created confusion of terms, no author has proposed a new definition.…”

Identification of periductal mastitis and granulomatous lobular mastitis: a literature review

“…Moreover, because GLM usually presents as a fairly large breast mass, surgical resection often leads to poor plastic results and severe breast malformations. In order to improve this result, Zhang et al (119) have conducted clinical study on stage I implant breast reconstruction after surgical resection of lesions. The results showed that after primary prosthesis implantation, patients had higher breast shape satisfaction (88.9%) and lower postoperative infection rate (5.6%), suggesting that this method can be used as an optional method for breast reconstruction in patients after larger lesion resection.…”