Scoring Idiopathic Granulomatous Mastitis:  An Effective System for Predicting Recurrence?

Yılmaz, Tonguç Utku; Gürel, Bora; Güler, Sertaç Ata; Baran, Mehmet Ali; Ersan, Busra; Duman, Seda; Utkan, Zafer

doi:10.5152/ejbh.2018.3709

Cited by 36 publications

(45 citation statements)

References 23 publications

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“…A growing evidence suggesting that the degree of inflammation, the presence of pus, and the presence of extra-mammary findings are indicative of the severity of IGM (Akin et al, 2017;Yılmaz et al, 2018) is in harmony with the potential clinical usefulness of our proposed classification. The observation that such patients will benefit from the early introduction of systemic steroids was supported by a recent study (Uysal et al, 2018).…”

Section: Discussionsupporting

confidence: 61%

“…With the exception of one recent report (Uysal et al, 2018), statistically based data on the predictors of recurrence of IGM are still lacking. In a recent publication (Yılmaz et al, 2018) retrospectively analyzed data about 53 patients with IGM to establish a severity score to predict the possibility of recurrence of IGM. The number of births, duration of lactation, BMI, presence of fistulas, abscess formation, and luminal inflammation were found to be significantly different between recurring and non-recurring patients.…”

Section: A Proposal Of a Clinically Based Classification For Idiopathmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 61%

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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“…In the literature, there is a great variety of findings related to the risk of recurrence for the different therapeutic approaches [33]. It comes as no surprise that antibiotics seem to have the lowest efficacy in the treatment of this abacterial mastitis with improvement rates ranging from 6 to 21% (table 1).…”

Section: Treatmentmentioning

confidence: 99%

“…Yilmaz et al [33] tried to define a scoring system to predict recurrence, which failed due to the relatively low incidence of recurrence in their study with only 8 out of 63 patients.…”

Section: Treatmentmentioning

confidence: 99%

Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge

et al. 2018

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Granulomatous mastitis (GM) is a rare benign inflammatory breast disease that affects mostly women of childbearing age with a history of breastfeeding. The etiopathogenesis is still unknown; however, inflammation as the result of a reaction to trauma, metabolic or hormonal processes, autoimmunity, and an infection with Corynebacterium kroppenstedtii have all been implicated. Clinical findings are pain, mass, hyperemia, and inflammation. Because the clinical presentation can mimic infectious mastitis or inflammatory carcinoma, the disease course is often protracted. The diagnosis is made by histopathology. Biopsies show a granulomatous formation in combination with a localized infiltration of multi-nucleated giant cells, epithelioid histiocytes, and plasma cells. Ultrasound, mammography, and magnetic resonance imaging are not specific; however, ultrasound and mammography should be done to exclude other pathologies. Due to the lack of data including randomized controlled studies, the management of GM is controversial. In Western industrialized countries, most authors use a therapy regimen starting with antibiotics and corticosteroids, followed by continuous steroid therapy and surgery in patients with persisting symptoms. More data are needed to define the best therapy. The role of immunotherapy has not yet been ascertained. The implementation of a registry to collect more information on this rare disease is highly recommended.

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“…However, despite apparent curative surgical excision, a recurrence rate of up to 13% is reported. 11 Appropriate treatment will be determined by the size and location of the lumps and skin lesions as well as the disease severity and patient preferences. Multidisciplinary care with input from a breast physician, surgeon, pathologist, radiologist and breast care nurse is ideal, with referral to an immunologist if methotrexate is considered.…”

Section: Managementmentioning

confidence: 99%

Granulomatous lobular mastitis: Clinical update and case study

Brennan¹,

Morgan

Heilat

et al. 2020

Aust J Gen Pract

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Scoring Idiopathic Granulomatous Mastitis: An Effective System for Predicting Recurrence?

Abstract: Granulomatous mastitis score is a tool targeted at predicting the risk of recurrences. The patients with these factors are more prone for recurrences.

Cited by 36 publications

References 23 publications

A Proposal of a Clinically Based Classification for Idiopathic Granulomatous Mastitis

A Proposal of a Clinically Based Classification for Idiopathic Granulomatous Mastitis

Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge

Granulomatous lobular mastitis: Clinical update and case study

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