IgG4-related mastitis requiring differentiation from breast cancer: a case report

Asano, Yuka; Kashiwagi, Shinichiro; Kawano, Yuko; Tanaka, Sayaka; Kuwae, Yuko; Takashima, Tsutomu; Ohsawa, Masahiko; Hirakawa, Kosei; Ohira, Masaichi

doi:10.1093/jscr/rjaa240

Cited by 9 publications

(1 citation statement)

References 10 publications

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“…According to previous reports, half of the cases of IgG4-associated mastitis were asymptomatic, i.e., mass without pain or redness, while the remainder had breast induration and mastalgia [ 3 , 5 , 6 ]. In the present case, the patient showed an asymptomatic breast mass with extensive skin thickening of the right breast.…”

Section: Discussionmentioning

confidence: 99%

IgG4-related mastitis characterized by skin thickening of the breast: a case report

Itakura,

Horimoto,

Ishizuka

et al. 2023

surg case rep

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Background IgG4-related diseases are characterized by marked infiltration and IgG4-positive plasma cells and fibrosis, and involve multiple organs. However, IgG4-related mastitis is rare. We report a case of mastitis associated with IgG4-related disease. Case presentation A 78-year-old woman visited our hospital with a complaint of multiple subcutaneous nodules. A biopsy of a dorsal subcutaneous mass was performed but did not yield a definitive diagnosis. However, blood tests showed a high level of IgG4, thus she was referred to the department of collagen disease for further examination. Computed tomography (CT) showed a thickening of the skin of the right breast, and the patient was referred to our department. On physical examination, a large area of thickened skin was observed in the right breast without inflammatory breast cancer-like redness, and no mass was palpable. A needle biopsy was performed on an indistinct hypoechoic area in the breast, and she was diagnosed with mastitis associated with IgG4-related disease. Systemic steroid therapy was then administered and the symptoms of multiple skin nodules and mastitis improved. Conclusions We reached the diagnosis based on a biopsy of the mammary gland enabling the patient to begin treatment for IgG4-related disease. This case was characterized by breast skin thickening, which is different from inflammatory breast cancer.

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Section: Discussionmentioning

confidence: 99%

IgG4-related mastitis characterized by skin thickening of the breast: a case report

Itakura,

Horimoto,

Ishizuka

et al. 2023

surg case rep

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The role of tissue IgG4 levels in steroid therapy in patients with idiopathic granulomatous mastitis

Seyidli,

Aydoğdu,

Büyükkasap

et al. 2024

Clin Exp Med

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Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory lesion of the breast. Immunoglobulin G4 (IgG4) associated disease is rare in the breast. In our study, we aimed to evaluate the efficacy of steroid treatment on IgG4 levels in tissue in patients diagnosed with IGM. Between 2008 and 2017, 55 patients diagnosed with IGM in our clinic were included in the study. Demographic, clinical, microbiologic and histopathologic characteristics, treatment modality and recovery time were evaluated retrospectively. Patients were divided into 3 groups according to tissue IgG4 levels: negative (Group I), infrequently and slightly positive (Group II), and highly positive (Group III). Group I patients had a complete response rate of 77.8%. In the rest of the patients (22.2%), insufficient response was detected from the beginning of the treatment. In Group II, the response rate was 91.3% and the permanent success rate after treatment was 87.0%. Although group III patients had a complete response at the beginning (95.65%), they relapsed in a short period of time (26.1%) after discontinuation of steroid treatment. At least one steroid-related side effect was observed in 47 (85.8%) patients in all groups. There is no consensus on the dose and duration of immunosuppressive treatment in IGM. In this study, responses to steroid treatment according to IgG4 concentration in pathologic breast tissue and recurrences after the end of treatment were determined. We think that high IgG4 concentration in the tissue is associated with recurrence and other immunosuppressive drugs should be added as maintenance after steroid treatment.

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Diagnóstico por PET con 18F-FDG de mastitis bilateral uniorgánica relacionada con IgG4

Garcia,

Compte,

Kauak

et al. 2024

Revista Española de Medicina Nuclear e Imagen Molecular

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IgG4-related mastitis requiring differentiation from breast cancer: a case report

Cited by 9 publications

References 10 publications

IgG4-related mastitis characterized by skin thickening of the breast: a case report

IgG4-related mastitis characterized by skin thickening of the breast: a case report

The role of tissue IgG4 levels in steroid therapy in patients with idiopathic granulomatous mastitis

Diagnóstico por PET con 18F-FDG de mastitis bilateral uniorgánica relacionada con IgG4

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