Corticosteroid treatment in the management of idiopathic granulomatous mastitis to avoid unnecessary surgery.

Abstract

PURPOSE:

Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. It can mimic breast carcinoma clinically and radiologically, and usually affects females of childbearing age. There is no commonly accepted optimal treatment for IGM. In this study, we present the clinical and histopathological features and outcomes of the therapeutic management of IGM, as well as the clinical course of the disease when patients were treated with oral corticosteroids.

METHODS:

This retrospective study included 49 of 87 patients who met the required histological criteria for IGM who were followed up between January 2009 and December 2011. All patients had a disease-free follow-up period of at least 6 months. The data regarding the clinical features at presentation, laboratory values and the treatment modalities were obtained from the medical records of the patients.

RESULTS:

The mean age of the patients was 34.3 ± 4.37 years. Forty patients were treated with prednisolone, five were started on antituberculosis treatment, two received non-steroidal anti-inflammatory drugs, one received antibiotics and one underwent wide excision. All patients who received steroids responded well to the therapy.

CONCLUSION:

Systemic therapy with corticosteroids is an effective and appropriate treatment option for IGM. It can provide complete disease resolution and prevent recurrence in the long term. A multidisciplinary approach including specialists in the fields of both general surgery and infectious diseases is essential for the diagnosis, treatment and follow-up of IGM.

• Authors: Tulay Mizrakli, Mehmet Velidedeoglu, Mucahit Yemisen, Birgul Mete, Fahrettin Kilic, Halit Yilmaz, Tulin Ozturk, Resat Ozaras, Fatih Aydogan, Asiye Perek
• Journal: Surgery today (Surg Today) Vol. 45 Issue 4 Pg. 457-65 (Apr 2015) ISSN: 1436-2813 [Electronic] Japan
• PMID: 24993812 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Anti-Bacterial Agents
• Anti-Inflammatory Agents, Non-Steroidal
• Antitubercular Agents
• Prednisolone

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Antitubercular Agents (therapeutic use)
• Breast Neoplasms
• Diagnosis, Differential
• Female
• Follow-Up Studies
• Granulomatous Mastitis (diagnosis, drug therapy, pathology, prevention & control)
• Humans
• Interdisciplinary Communication
• Patient Care Team
• Prednisolone (therapeutic use)
• Recurrence
• Retrospective Studies
• Time Factors
• Treatment Outcome