The Surgical Management of Granulomatous Mastitis

Abstract

Granulomatous mastitis is an inflammatory breast condition of unknown etiology. Management remains controversial and treatment algorithms are lacking from the literature. Few resources exist that discuss breast reconstruction following extirpation. This descriptive case series reviews the clinicopathologic features of granulomatous mastitis.We describe the surgical management undertaken at our institution including General and Plastic Surgery procedures. Eleven clinical charts and histologic slides of biopsy specimens were reviewed in our health region between 1992 and 2007. Demographic data, clinical presentation, and radiologic findings were tabulated. Treatment consisted of empirical antibiotics and surgical excision. Procedures performed included incision and drainage (n = 8), excisional biopsy (n = 15), partial mastectomy (n = 5), partial mastectomy with reduction mammaplasty (n = 2), and mastectomy with TRAM flap reconstruction (n = 1).Treatment was successful in all but one case. Multiple surgeries for recurrent lesions were often required to achieve final remission. Following extirpation, we recommend delayed breast reconstruction to monitor for recurrence.

Idiopathic granulomatous mastitis: an institutional experience

“…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.…”

Topical Steroids Are Effective in the Treatment of Idiopathic Granulomatous Mastitis

“…Consistent with our conclusion, cases requiring repeated surgical intervention and excision extensive enough to require reconstruction have been reported in the literature [10]. Thus, it is inappropriate to use either of these two different groups of patients as a control group because we chose surgery or topical steroid treatment for different clinical situations.…”

Methotrexate in the Management of Idiopathic Granulomatous Mastitis: Review of 108 Published Cases and Report of Four Cases

“…Granulomatous mastitis is a rare benign inflammatory breast disease that often clinically simulates carcinoma. Diagnosis should be made not only histopathologically but also according to clinical or radiological appearances (5,8,35,39). The two types of GM are defined as specific and idiopathic (30,35).…”