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 JBM  Vol.7 No.6 , June 2019
Granulomatous Mastitis: Incidence and Experience in a Mexican Institute
Abstract: The significance of this work is that chronic granulomatous disease can mimic two common breast diseases; breast cancer and breast abscess; so it is mandatory that the diagnosis is made in order to avoid mistaken carcinoma diagnosis. On the other hand, the current treatment of this particular disease still remains controversial. Objectives: The aim of this study is to expose and describe the chronicity and the impact in a patient’s quality of life with Granulomatous Mastitis diagnosis. We describe the evolution of the disease and the treatment of the disease in a Mexican Institution. Material and methods: In a descriptive retrospective study we identified 9 patients with idiopathic granulomatous mastitis (IMG), all of them were diagnosed with histopathological findings. Results: In a period of time between January 2005 and December 2017, we included a total of 9 female patients. All of them have had histopathological findings consistent with granulomatous mastitis. The age range was 25 - 83 years old (mean 50.8 yrs). In 4 patients (44.4%) had the right side affected, three patients (33.3%) had the left side affected and 2 patients (22.2%) had a bilateral presentation. In 3 patients (33.3%) we observed more than one affected quadrant and 4 patients (44.4%) had a diffuse presentation on image. The most common symptom was breast pain in 9 patients (100%) and the most common sign was the presence of a nodule, 8 patients (88.8%). We observed erythema in 7 cases (77.7%) followed by abscess, edema and pus secretion in 6 patients (66.6%). The most frequent treatment was the use of a combination of NAIDs and antibiotic in 8 patients (88.8%). Six patients were incised with scalp and drained. Six patients underwent mastectomy.
Cite this paper: Topete, A. , Carrasco, O. , Barrera, G. , Garzón, J. , Gutierrez, E. , Márquez, C. , Dávila, R. , Cuervo, M. and Rivera, M. (2019) Granulomatous Mastitis: Incidence and Experience in a Mexican Institute. Journal of Biosciences and Medicines, 7, 24-32. doi: 10.4236/jbm.2019.76003.
References

[1]   Kessler, E. and Wolloch, Y. (1972) Granulomatous Mastitis: A Lesion Clinically Simulating Carcinoma. American Journal of Clinical Pathology, 58, 642-646.
https://doi.org/10.1093/ajcp/58.6.642

[2]   Brown, K. and Tang, P. (1979) Postlactationaltumoral Granulomatous Mastitis: A Localized Immune Phenomenon. The American Journal of Surgery, 138, 326-329.
https://doi.org/10.1016/0002-9610(79)90397-0

[3]   Fletcher, A., Magrath, I., Riddell, R. and Talbot, I. (1982) Granulomatous Mastitis: A Report of Seven Cases. Journal of Clinical Pathology, 35, 941-945.
https://doi.org/10.1136/jcp.35.9.941

[4]   Rowe, P.H. (1984) Granulomatous Mastitis Associated with a Pituitary Prolactinoma. British Journal of Clinical Practice, 38, 32-34.

[5]   Ogura, K., Matsumoto, T., Aoki, Y., Kitabatake, T., Fujisawa, M. and Kojima, K. (2010) IgG4-Related Tumour-Forming Mastitis with Histological Appearances of Granulomatous Lobular Mastitis: Comparison with Other Types of Tumour-Forming Mastitis. Histopathology, 57, 39-45.
https://doi.org/10.1111/j.1365-2559.2010.03581.x

[6]   Akahane, K., et al. (2013) Therapeutic Strategy for Granulomatous Lobular Mastitis: A Clinicopathological Study of 12 Patients. Nagoya Journal of Medical Science, 75, 193-200.

[7]   Lacambra, M., Thai, T., Lam, C., Yu, A., Pham, H., Tran, P., et al. (2011) Granulomatous Mastitis: The Histological Differentials. Journal of Clinical Pathology, 64, 405-411.
https://doi.org/10.1136/jcp.2011.089565

[8]   Patel, et al. (2009) Idiopathic Granulomatous Mastitis: Case Reports and Review of Literature. Journal of General Internal Medicine, 25, 270-273.
https://doi.org/10.1007/s11606-009-1207-2

[9]   Bani-Hani, K., Yaghan, R., Matalka, I. and Shatnawi, N. (2004) Idiopathic Granulomatous Mastitis: Time to Avoid Unnecessary Mastectomies. The Breast Journal, 10, 318-322.
https://doi.org/10.1111/j.1075-122X.2004.21336.x

[10]   Katz, U., Molad, Y., Ablin, J., et al. (2007) Chronic Idiopathic Granulomatous Mastitis. Annals of the New York Academy of Sciences, 1108, 603-608.
https://doi.org/10.1196/annals.1422.063

[11]   Lai, E., Chan, W., Ma, T., Tang, A., Poon, C. and Leong, H. (2005) The Role of Conservative Treatment in Idiopathic Granulomatous Mastitis. The Breast Journal, 11, 454-456.
https://doi.org/10.1111/j.1075-122X.2005.00127.x

[12]   Asoglu, O., Ozmen, V., Karanlik, H., Tunaci, M., Cabioglu, N., Igci, A., et al. (2005) Feasibility of Surgical Management in Patients with Granulomatous Mastitis. The Breast Journal, 11, 108-114.
https://doi.org/10.1111/j.1075-122X.2005.21576.x

[13]   Binesh, F. (2014) Idiopathic Granulomatous Mastitis, a Clinico-pathological Review of 22 Cases. Journal of Clinical & Experimental Pathology, 4, 157.
https://doi.org/10.4172/2161-0681.1000157

[14]   Agale, S.V., Momin, Y.A. and Khan, W.A. (2009) Cytology of Idiopathic Granulomatous Mastitis: A Report of a Case Masquerading as Carcinoma. Bombay Hospital Journal, 51, 105.

[15]   DeHertogh, D., Rossof, A., Harris, A. and Economou, S. (1980) Prednisone Management of Granulomatous Mastitis. New England Journal of Medicine, 303, 799-800.
https://doi.org/10.1056/NEJM198010023031406

[16]   Azlina, A., Ariza, Z., Arni, T. and Hisham, A. (2003) Chronic Granulomatous Mastitis: Diagnostic and Therapeutic Considerations. World Journal of Surgery, 27, 515-518.
https://doi.org/10.1007/s00268-003-6806-1

[17]   Kim, J., Tymms, K. and Buckingham, J. (2003) Methotrexate in the Management of Granulomatous Mastitis. ANZ Journal of Surgery, 73, 247-249.
https://doi.org/10.1046/j.1445-1433.2002.02564.x

[18]   Raj, N. (2004) Rheumatologists and Breasts: Immunosuppressive Therapy for Granulomatous Mastitis. Rheumatology, 43, 1055-1056.
https://doi.org/10.1093/rheumatology/keh246

[19]   Ahmed, Y. and Abd El Maksoud, W. (2016) Evaluation of Therapeutic Mammoplasty Techniques in the Surgical Management of Female Patients with Idiopathic Granulomatous Mastitis with Mild to Moderate Inflammatory Symptoms in Terms of Recurrence and Patients’ Satisfaction. Breast Disease, 36, 37-45.
https://doi.org/10.3233/BD-150198

[20]   Schelfout, K., Tjalma, W.A., Cooremans, I.D., Coeman, D.C., Colpaert, C.G. and Buytaert, P.M. (2001) Observations of an Idiopathic Granulomatous Mastitis. European Journal of Obstetrics & Gynecology and Reproductive Biology, 97, 260-262.
https://doi.org/10.1016/S0301-2115(00)00546-7

[21]   Imoto, S., Kitaya, T., Kodama, T., Hasebe, T. and Mukai, K. (1997) Idiopathic Granulomatous Mastitis: Case Report and Review of the Literature. Japanese Journal of Clinical Oncology, 27, 274-277.
https://doi.org/10.1093/jjco/27.4.274

[22]   Vinayagam, R., Cox, J. and Webb, L. (2009) Granulomatous Mastitis: A Spectrum of Disease. Breast Care, 4, 251-254.
https://doi.org/10.1159/000229541

[23]   Kayahan, M., Kadioglu, H. and Muslumanoglu, M. (2012) Management of Patients with Granulomatous Mastitis: Analysis of 31 Cases. Breast Care, 7, 226-230.
https://doi.org/10.1159/000337758

[24]   Memis, A., Bilgen, I., Ustun, E.E., et al. (2002) Granulomatous Mastitis: Imaging Findings with Histopathologic Correlation. Clinical Radiology, 57, 1001-1006.
https://doi.org/10.1053/crad.2002.1056

[25]   Uysal, E., Soran, A. and Sezgin, E. (2017) Factors Related to Recurrence of Idiopathic Granulomatous Mastitis: What Do We Learn from a Multicentre Study? ANZ Journal of Surgery, 88, 635-639.
https://doi.org/10.1111/ans.14115

[26]   Akcan, A., Akyndiz, H., Deneme, M., et al. (2006) Granulomatous Lobular Mastitis: A Complex Diagnostic and Therapeutic Problem. World Journal of Surgery, 30, 1403-1409.
https://doi.org/10.1007/s00268-005-0476-0

[27]   Going, J.J., Anderson, T.J., Wilkinson, S. and Chetty, U. (1987) Granulomatous Lobular Mastitis. Journal of Clinical Pathology, 40, 535-540.
https://doi.org/10.1136/jcp.40.5.535

[28]   Ozmen, V., Cantürk, Z., Celik, V., et al. (2012) Breast Disease. Federation of Breast Diseases Society, Gunes Medical Publishing, Ankara.

 
 
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