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. 2014 May;9(2):111-5.
doi: 10.1159/000360926.

Idiopathic Granulomatous Mastitis: Comparison of Wide Local Excision with or without Corticosteroid Therapy

Alper Akcan  1 , A Bahadir Oz  1 , Serap Dogan  1 , Hülya Akgün  1 , Muhammet Akyüz  1 , Engin Ok  1 , Mustafa Gök  1 , Tutkun Talih  1
Affiliations

Idiopathic Granulomatous Mastitis: Comparison of Wide Local Excision with or without Corticosteroid Therapy

Alper Akcan et al. Breast Care (Basel). 2014 May.

Abstract

Background: Idiopathic granulomatous mastitis (IGM) is an uncommon chronic inflammatory disease of the breast with uncertain optimal treatment regimen. In this study, our purpose was to report our clinical experience with 74 IGM patients who were treated wide local excision with or without steroid therapy.

Patients and method: 74 cases diagnosed histologically as IGM were identified from surgical and pathological records between January 1995 and January 2012. Group 1 (surgery-only group) comprised 53 patients, and the 21 patients in group 2 were treated with corticosteroids prior to surgical treatment (steroid-and-surgery group).

Results: Follow-up data were complete for 67 (91.7%) of the 73 patients. Recurrence developed in 4 (7.5%) patients in the surgery-only group, while there was no recurrence in the steroid-and-surgery group; the difference was not statistically significant (p = 0.19).

Conclusion: Systemic steroid therapy with surgical resection is the recommended first-line treatment strategy for IGM.

Keywords: Corticosteroid therapy; Idiopathic granulomatous mastitis; Wide excision.

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Figures

Fig. 1
Fig. 1
View of the left breast in an IGM patient with fistula formation.
Fig. 2
Fig. 2
MMG in a 30-year-old woman. On the craniocaudal mammogram of both breasts, a focal asymmetrical density with indistinct margins is seen in the retroareolar area of the right breast (proven to be granulomatous mastitis by histopathology).
Fig. 3
Fig. 3
MRI in a 37-year-old woman. (a) Precontrast and (b) dynamic contrast-enhanced MRI showing irregular heterogeneous enhancement in the outer quadrant of the right breast (proven to be granulomatous mastitis by histopathology), with skin involvement. (c) Type II enhancement is seen from the time-intensity curve.
See this image and copyright information in PMC

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