Granulomatous mastitis: Presentation, treatment and outcome in 43 patients

Kok, Kenneth Y.Y.; Telisinghe, Pemasari Upali

doi:10.1016/j.surge.2010.02.002

Cited by 107 publications

(123 citation statements)

References 33 publications

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“…According to literature, IGM typically affects parous females in the reproductive age group (1,12,13,(17)(18)(19). These findings were confirmed in our study, although there were exceptions.…”

Section: Discussionsupporting

confidence: 91%

“…The disease is particularly troublesome for the patient because of its stubborn tendency to recur. Autoimmunity, pregnancy, lactation, hyperprolactinemia, oral contraceptive use, local trauma to the breast, alpha-1 antitrypsin deficiency and smoking have all been described as risk factors for the occurrence of the disease (12)(13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

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Idiopathic granulomatous mastitis: an institutional experience

et al. 2017

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Idiopathic granulomatous mastitis: an institutional experience

et al. 2017

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“…Clinically, it can present as a breast mass with features similar to those of breast malignancy (2). Multiple infective and inflammatory conditions, including tuberculosis (TB), fungal infections, sarcoidosis, amyloidosis, and Wegener's granulomatosis, have been recognized, but recently, attention has been drawn to corynebacterial species as a specific pathogen in this disease.…”

mentioning

confidence: 99%

Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

et al. 2015

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cCorynebacterium species are increasingly recognized as important pathogens in granulomatous mastitis. Currently, there are no published treatment protocols for Corynebacterium breast infections. This study describes antimicrobial treatment options in the context of other management strategies used for granulomatous mastitis. Corynebacterium spp. isolated from breast tissue and aspirate samples stored from 2002 to 2013 were identified and determined to the species level using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS), 16S RNA sequencing, and rpoB gene targets. The MICs for 12 antimicrobials were performed using Etest for each isolate. Correlations of these with antimicrobial characteristics, choice of antimicrobial, and disease outcome were evaluated. Corynebacterium spp. from breast tissue and aspirate samples were confirmed in 17 isolates from 16 patients. Based on EUCAST breakpoints, Corynebacterium kroppenstedtii isolates (n ‫؍‬ 11) were susceptible to seven antibiotic classes but resistant to ␤-lactam antibiotics. Corynebacterium tuberculostearicum isolates (n ‫؍‬ 4) were multidrug resistant. Two nonlipophilic species were isolated, Corynebacterium glucuronolyticum and Corynebacterium freneyi, both of which have various susceptibilities to antimicrobial agents. Short-course antimicrobial therapy was common (median, 6 courses per subject; range, 1 to 9 courses). Patients with C. kroppenstedtii presented with a hot painful breast mass and underwent multiple surgical procedures (median, 4 procedures; range, 2 to 6 procedures). The management of Corynebacterium breast infections requires a multidisciplinary approach and includes culture and appropriate sensitivity testing to guide antimicrobial therapy. Established infections have a poor outcome, possibly because adequate concentrations of some drugs will be difficult to achieve in lipophilic granulomata. Lipophilic antimicrobial therapy may offer a therapeutic advantage. The role of immunotherapy has not been defined. Granulomatous mastitis (GM) is a rare inflammatory condition that typically occurs in parous women of reproductive age (1). Clinically, it can present as a breast mass with features similar to those of breast malignancy (2). Multiple infective and inflammatory conditions, including tuberculosis (TB), fungal infections, sarcoidosis, amyloidosis, and Wegener's granulomatosis, have been recognized, but recently, attention has been drawn to corynebacterial species as a specific pathogen in this disease. Typically, corynebacterial breast infections are characterized by abscess formation, granulomatous inflammation, and progression to sinus/fistula formation (3). This and other specific diagnoses should be excluded before a diagnosis of idiopathic granulomatous mastitis (IGM) is made (3-5).Commonly, it is the lipophilic species of the Corynebacterium genus that cause mastitis (3, 6-8). As such, a microbiological diagnosis can be challenging, due to their fastidious growth requirements and prolonged incu...

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“…La mastitis granulomatosa lobular o idiopática (MGI), una enfermedad benigna de etiología no definida, afecta también a mujeres jóvenes en edad reproductiva, presenta compromiso unilateral predominante y se manifiesta como un nódulo o absceso con retracción del pezón, ulceración, fistulización y síntomas sistémicos infrecuentes. No obstante, este diagnóstico amerita además de características anatomo-patológicas típicas, el descarte de otras causas de mastitis granulomatosa (20)(21)(22)(23)(24)(25).…”

Section: Discussionunclassified

“…Esta cifra discrepa con la tasa de éxito de más del 95% para tratamiento médico en TB de mama descrita por diferentes autores (4,7,(8)(9)(10). En cambio, en MGI el tratamiento óptimo aun es controversial y por lo general la recurrencia puede presentarse en 40 a 50% de los casos (21). Cuando se evaluaron las características clínicas, los resultados de los exámenes auxiliares y los hallazgos anatomo-patológicos según el tipo de evolución, se observó que no había diferencias significativas en ningún caso.…”

Section: Discussionunclassified

Características clínicas y anatomo-patológicas de las pacientes que ingresaron al Programa de Control de Tuberculosis con diagnóstico de tuberculosis de mama

Tafur¹,

Cáceres²,

Accinelli³

2014

Rev Med Hered

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Objetivo: Describir las características clínicas y anatomo-patológicas de pacientes que ingresaron con diagnóstico de TB de mama al Programa de control de Tuberculosis (PCT) de un hospital general. Material y métodos: Se incluyeron los casos registrados en el PCT como TB de mama en cuyo informe anatomo-patológico figuraba inflamación crónica granulomatosa. Se revisaron las historias clínicas y revaluaron las biopsias de mama. Resultados: Se incluyeron 69 mujeres con edad promedio 35,79 ± 7,94 años. Las manifestaciones más frecuentes fueron presencia de nódulo (89,86%), dolor (89,86%) y signos inflamatorios (40,58%). La revaluación de la biopsia mostró granulomas de tipo supurado, con células gigantes multinucleadas tipo Langhans y cuerpo extraño, sin necrosis caseosa, localizados a nivel de la unidad ducto lobular (UDL) y extra-UDL en 85,51 % de los casos. Solo en 3 casos se observó bacilos ácido alcohol resistente en la secreción o tejido de mama. Todos los casos recibieron tratamiento antituberculoso. Treinta y ocho casos tuvieron seguimiento, de ellos 73,68% presentó persistencia o recurrencia al menos un mes después del inicio de tratamiento antituberculoso. Conclusiones: Todos los casos del estudio fueron mujeres, la mayoría presentaron nódulo, dolor o signos de inflamación en mama, sin síntomas o signos sistémicos y con presencia de granulomas supurados, sin necrosis caseosa. A pesar de recibir tratamiento antituberculoso en todos los casos, cerca del 75% con seguimiento de al menos un mes presentaron persistencia o recurrencia clínica.

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Granulomatous mastitis: Presentation, treatment and outcome in 43 patients

Cited by 107 publications

References 33 publications

Idiopathic granulomatous mastitis: an institutional experience

Idiopathic granulomatous mastitis: an institutional experience

Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

Características clínicas y anatomo-patológicas de las pacientes que ingresaron al Programa de Control de Tuberculosis con diagnóstico de tuberculosis de mama

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