Idiopathic Granulomatous Mastitis: Comparison of Wide Local Excision with or without Corticosteroid Therapy

Abstract

Background: Idiopathic granulomatous mastitis (IGM) is an uncommon chronic inflammatory disease of the breast with uncertain optimal treatment regimen. In this study, our purpose was to report our clinical experience with 74 IGM patients who were treated wide local excision with or without steroid therapy. Patients and Method: 74 cases diagnosed histologically as IGM were identified from surgical and pathological records between January 1995 and January 2012. Group 1 (surgery-only group) comprised 53 patients, and the 21 patients in group 2 were treated with corticosteroids prior to surgical treatment (steroid-and-surgery group). Results: Follow-up data were complete for 67 (91.7%) of the 73 patients. Recurrence developed in 4 (7.5%) patients in the surgery-only group, while there was no recurrence in the steroid-and-surgery group; the difference was not statistically significant (p = 0.19). Conclusion: Systemic steroid therapy with surgical resection is the recommended first-line treatment strategy for IGM.

Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge

“…Every-2-week visits should take place to evaluate treatment response and possible side effects. Corticosteroids should be administered for a minimum of 8 weeks and a maximum of 6 months to minimize possible side effects [34]. …”

Idiopathic granulomatous mastitis: A systematic review of 3060 patients

“…The characteristic of reviewed articles is summarized in Table (). The total number of articles was 70, 59 in group A and 11 in group B.…”

“…The characteristic of reviewed articles is summarized in Table 1( [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]…”

Surgical treatment of granulomatous mastitis: Our experience in Bahrain

“…Furthermore, steroids can exacerbate infectious diseases of the breast . Steroids can be used for unresectable lesions before surgery or those with complicated and resistant GM after surgical excision . In our experience, there is no role for corticosteroids, as one patient was previously diagnosed with GM and kept on long‐term prednisolone without improvement of her symptoms.…”

“…Other authors advocate wide surgical excision, with or without corticosteroid treatment . The main point is limiting the possibility of recurrence and minimizing complications associated with steroid therapy, therefore, wide excision of the involved inflammatory tissue provides a better outcome .…”