Granulomatous Inflammation of the Breast in a Pregnant Woman

Poniecka, Anna W.; Krasuski, Piotr; Gal, E.; Lubin, Jack; Howard, Lydia; Poppiti, Robert

doi:10.1159/000328309

Cited by 26 publications

(9 citation statements)

References 19 publications

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“…Rami Yaghan 1 *, Shadi Hamouri 1 , Nehad M Ayoub 2 , Lamees Yaghan 1 , Tagleb Mazahreh 1 linked to parity, lactation, and pregnancy (Mahmodlou et al, 2017;Poniecka et al, 2001). Associations with alpha1-antitrypsin deficiency and hyperprolactinemia have also been reported (Bani-Hani et al, 2004;Mahmodlou et al, 2017;Altintoprak et al, 2014).…”

Section: A Proposal Of a Clinically Based Classification For Idiopathmentioning

confidence: 99%

A Proposal of a Clinically Based Classification for Idiopathic Granulomatous Mastitis

Yaghan

Hamouri

Ayoub

et al. 2019

Asian Pac J Cancer Prev

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Objectives:There is no consensus regarding the surgical or immunosuppressive treatment of idiopathic granulomatous mastitis (IGM). This study aimed to introduce a clinical classification system for IGM that might facilitate its treatment and predict recurrence.Methods:We analyzed the management of 68 patients with IGM at (Princess Basma Teaching Hospital and King Abdulla University Hospital (1994-2016) to find out if distinct patterns of presentation exist according to the following parameters: presence of a painful or painless breast mass, local inflammation, abscess formation, communication to the skin, and extra-mammary manifestation.Results:We identified four distinct patterns of IGM: A: (13.23 %) A hard, painless breast mass. B: (52.94 %) A hard, painful breast mass with gross inflammation. C: (26.47 %) A breast abscess-like presentation. D: (7. 35 %) A subacute presentation with ulceration, sinus, or fistula formation. Erythema nodosum might complicate any of these patterns. Wide local excision in pattern A was curative with zero recurrence rate. The recurrence rates in patterns B and C were 22.20 % and 50.00 %. Patterns B, C, and D were treated by a combination of surgery and prednisolone. In keeping with this, recent literature is in favor of a wider use of immunosuppression especially in the presence of pus and extra-mammary findings.Conclusion:IGM could be classified into 4 distinct patterns according to the presenting signs and symptoms. These patterns correlated with treatment, recurrence rate, and the gross operative findings. This is the first step toward a classification for IGM. Multicenter and Meta-analysis studies are essential for a comprehensive prognostic classification. Treatment of IGM in any institution should be the responsibility of a multidisciplinary team.

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Section: A Proposal Of a Clinically Based Classification For Idiopathmentioning

confidence: 99%

A Proposal of a Clinically Based Classification for Idiopathic Granulomatous Mastitis

Yaghan

Hamouri

Ayoub

et al. 2019

Asian Pac J Cancer Prev

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“…Granulomatous mastitis is a rare cause of C3 and C4 diagnosis [34,35,36,37,38,39]. It often presents as a mass that mimicks carcinoma clinically and radiologically.…”

Section: Clinical and Cytologic Mimickers Of Malignancymentioning

confidence: 99%

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

2013

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Objective: To review our experience and the literature on inconclusive/erroneous fine-needle aspirates (FNAs) of breast with the focus on the ‘true gray zone'. To describe the cytology, differential diagnosis, pitfalls and limitations of common and rare lesions. Study Design: We conducted a literature search focusing on breast FNAs with statistical data of C3 and C4 categories including false-positive and false-negative cases. Similar data from 2003 to 2009 was obtained from our institution. Results: C3 and C4 categories account for 3-17% of breast FNAs. Contributing factors are technical difficulties, inexperienced pathologists interpreting FNAs of breast and overlap of cytologic features of certain benign and malignant conditions; this last, ‘true gray zone' accounts for 2% of cases. Fibroadenoma, proliferative breast lesions, gynecomastia, infiltrating and in situ low-grade adenocarcinomas and tubular, cribriform, lobular and mucinous carcinomas are the most common problematic lesions. Granular cell tumor, adenomyoepithelioma, pregnancy-related lesions, fat necrosis, inflammatory and radiation changes, adenoid cystic carcinoma, spindle-cell lesions and Phyllodes tumor are less common. Conclusion: Inconclusive/erroneous FNAs of breast due to the ‘true gray zone' are rare. Most are due to the overlapping cytologic features of some benign and malignant conditions. Practical features that may help arrive at the correct diagnoses are elucidated.

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“…After performing a search in different repositories (PubMed, Lilacs, Scopus, and Google scholar), we found that the potential usefulness of FNAC to identify granulomatous mastitis, as shown in our case, was in accordance with the study of Akcan et al 4 However, two different groups found opposite results about the FNAC's utility, and they emphasize the great difficulty to differentiate a carcinoma from a granulomatous mastitis with this kind of biopsy. 5,6 A combination of the lack of adequate training and experience in FNAC, technique execution and interpretation is probably the answer to these contradictory findings. 3 The presented patient was an 85-year-old female.…”

Section: Discussionmentioning

confidence: 99%

“…We agree with Bhaskaran et al 7 about plasma cell mastitis occurring in older women; nonetheless, there are two reports indicating that this kind of mastitis occurs more frequently in young females. 6,8 To increase the complexity of this issue, plasma cell mastitis is a rare form of mastitis, and its pathogenesis is not yet fully understood. [7][8][9] Plasma cell mastitis belongs to a rare group of granulomatous breast diseases.…”

Section: Discussionmentioning

confidence: 99%

“…8 Common opinion between experts of this field indicates that all forms of granulomatous mastitis can mimic breast cancer in clinical and radiological backgrounds. 2,[4][5][6][7][8] This is why the triple test score is essential for clinicians when evaluating palpable breast tumors: physical exam, radiologic evaluation (mammography and/or echography), and a biopsy. 3 As we can see in this case, the result of the biopsy changed the Fine-needle Aspiration Cytology Ortiz-Mendoza et al…”

Section: Discussionmentioning

confidence: 99%

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Fine-needle Aspiration Cytology to Identify a Rare Mimicker of Breast Cancer: Plasma Cell Mastitis

Ortiz-Mendoza

Sánchez

Dircio

2018

Rev Bras Ginecol Obstet

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There are rare benign diseases that can mimic malignant breast neoplasms in the clinical exam and in mammography. We evaluated the contribution of an accessible procedure to most clinicians, the fine-needle aspiration cytology, to identify a rare mimicker of malignant breast neoplasms. A type 2 diabetic 85-year-old female presented with a 6-month history of a left breast lump. The physical exam and mammography were compatible with breast cancer. Nevertheless, after fine-needle aspiration cytology, the diagnosis was plasma cell mastitis. Once this rare diagnosis was established, the tumor was extirpated, and the final histologic diagnosis corroborated chronic plasma cell mastitis. The patient's postoperative evolution was uneventful, and no other treatment was needed. Fine-needle aspiration cytology could be a valuable tool to identify rare mimickers of malignant breast neoplasms.

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Granulomatous Inflammation of the Breast in a Pregnant Woman

Cited by 26 publications

References 19 publications

A Proposal of a Clinically Based Classification for Idiopathic Granulomatous Mastitis

A Proposal of a Clinically Based Classification for Idiopathic Granulomatous Mastitis

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

Fine-needle Aspiration Cytology to Identify a Rare Mimicker of Breast Cancer: Plasma Cell Mastitis

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