Idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment

Mahmodlou, Rahim; Dadkhah, Niloofar; Abbasi, Fariba; Nasiri, Jafar; Valizadeh, Rohollah

doi:10.19082/5375

Cited by 39 publications

(40 citation statements)

References 10 publications

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“…However, simple drainage of such abscesses may often result in relapse . Drainage of abscess, extended resection, administration of antibiotics as well as steroid are often required for the treatment of nonpuerperal breast abscess. Considering the optimal management of nonpuerperal mastitis is still under controversy, patients with nonpuerperal breast abscess were not enrolled in our study.…”

Section: Discussionmentioning

confidence: 99%

Surgical drainage of lactational breast abscess with ultrasound‐guided Encor vacuum‐assisted breast biopsy system

et al. 2019

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Lactational breast abscess is a serious complication of mastitis and commonly diagnosed in breast‐feeding women. The traditional drainage of breast abscess was often performed with incisive technique which may result in prolonged healing time, regular dressings, dressing pain, interfering with breastfeeding and unsatisfactory cosmetic outcome. As minimal invasive alternatives to incisive drainage, needle aspiration or percutaneous catheter placement cannot completely replace incisive drainage for the inability to treat large, multiloculated or chronic abscess. Vacuum‐assisted breast biopsy system (VABB) has been successfully applied in the treatment of benign breast diseases with satisfactory cosmetic outcomes. Among VABB devices, EnCor system has some distinctive features that make it an appropriate candidate for the treatment of lactational breast abscesses. In this study, for the first time, we investigated the feasibility, efficacy, and cosmetic results of surgical drainage of lactational breast abscess with US‐guided Encor VABB system. Our data suggests this procedure could serve as a promising alternative for women with lactational breast abscess who require incisive intervention with high cure rate, relatively short healing time, low recurrence rate, few complications, satisfactory cosmetics outcome and without interfering with breastfeeding.

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Section: Discussionmentioning

confidence: 99%

Surgical drainage of lactational breast abscess with ultrasound‐guided Encor vacuum‐assisted breast biopsy system

et al. 2019

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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 wide local excision with steroid use is the most common treatment (Prasad et al, 2017;Deng et al, 2017;Mahmodlou et al, 2017). There is growing evidence that early introduction of immunosuppressive therapy might be useful in reducing the extent of surgery (Oran et al, 2013) Steroids are the most widely used agents in this context (Pandeyet 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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“…Breast biopsy is needed to clarify histopathological examination in order to exclude cancers or infections. Biopsy findings typically include noncaseous granulomatous lesions with leukocytosis, epithelioid cells, and macrophages, located in the center of breast lobule [11]. Although IGM is accompanied with noncaseous necrosis, acid-fast staining technique and tissue culture should be performed especially in tuberculosis-endemic areas [12].…”

Section: Discussionmentioning

confidence: 99%

Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence

Tekgöz¹,

Çolak²,

Çınar³

et al. 2020

Turk J Med Sci

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Background/aim: Idiopathic granulomatous mastitis is a rare, benign inflammatory disease of breast. There is no general agreement on the appropriate treatment choice. The aim of the study was to investigate the immunosuppressive administer for idiopathic granulomatous mastitis and risk factors related with disease recurrence. Materials and methods: The data of 53 patients with idiopathic granulomatous mastitis were evaluated for this cross-sectional retrospective study. Demographic features and clinical characteristics and course of the patients were obtained from file records. Results: The mean age of the patients was 37.2 ± 6.6 years. Fifty-one of 53 patients received immunosuppressive treatment with or without surgery. Forty-seven (88.6%) of the patients received only immunosuppressive treatment without surgery, while 4 (7.54%) patients received immunosuppressive treatment after surgery. Forty-one (77.3%) of 47 patients who had no surgical resection received methotrexate as immunosuppressive treatment. The other 6 (11.3%) patients received azathioprine or corticosteroid treatment. Complete or partial remission was observed in 50 (98%) of 51 patients who received immunosuppressive treatment, while only 1 (2%) patient did not reach remission. No factors were found related with recurrence of disease. Conclusion: Methotrexate seems to be efficient in the treatment of idiopathic granulomatous mastitis and provides drug-free remission.

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Idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment

Cited by 39 publications

References 10 publications

Surgical drainage of lactational breast abscess with ultrasound‐guided Encor vacuum‐assisted breast biopsy system

Surgical drainage of lactational breast abscess with ultrasound‐guided Encor vacuum‐assisted breast biopsy system

A Proposal of a Clinically Based Classification for Idiopathic Granulomatous Mastitis

Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence

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