Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence

Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence

Background/aim: Idiopathic granulomatous mastitis is a rare, benign inflammatory disease of breast. There is no general agreement on the appropriate treatment choice. The aim of the study was to investigate the immunosuppressive administer for idiopathic granulomatous mastitis and risk factors related with disease recurrence. Materials and methods: The data of 53 patients with idiopathic granulomatous mastitis were evaluated for this cross-sectional retrospective study. Demographic features and clinical characteristics and course of the patients were obtained from file records. Results: The mean age of the patients was 37.2 ± 6.6 years. Fifty-one of 53 patients received immunosuppressive treatment with or without surgery. Forty-seven (88.6%) of the patients received only immunosuppressive treatment without surgery, while 4 (7.54%) patients received immunosuppressive treatment after surgery. Forty-one (77.3%) of 47 patients who had no surgical resection received methotrexate as immunosuppressive treatment. The other 6 (11.3%) patients received azathioprine or corticosteroid treatment. Complete or partial remission was observed in 50 (98%) of 51 patients who received immunosuppressive treatment, while only 1 (2%) patient did not reach remission. No factors were found related with recurrence of disease. Conclusion: Methotrexate seems to be efficient in the treatment of idiopathic granulomatous mastitis and provides drug-free remission.

___

  • 1. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. American Journal of Clinical Pathology 1972; 58 (6): 642-646.
  • 2. Seo HR, Na KY, Yim HE, Kim TH, Kang DK et al. Differential diagnosis in idiopathic granulomatous mastitis and tuberculous mastitis. Journal of Breast Cancer 2012; 15 (1): 111-118. doi: 10.4048/jbc.2012.15.1.111
  • 3. Akbulut S, Yilmaz D, Bakir S. Methotrexate in the management of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases. Breast Journal 2011; 17 (6): 661- 668. doi: 10.1111/j.1524-4741.2011.01162.x
  • 4. Akcan A, Oz AB, Dogan S, Akgün H, Akyüz M et al. Idiopathic granulomatous mastitis : comparison of wide local excision with or without corticosteroid therapy. Breast Care (Basel) 2014; 9 (2): 111-115. doi: 10.1159/000360926
  • 5. Kim J, Tymms KE, Buckingham JM. Methotrexate in the management of granulomatous mastitis. ANZ Journal of Surgery 2003; 73 (4): 247-249.
  • 6. Hugon-Rodin J, Plu-Bureau G, Hugol D, Gompel A. Management of granulomatous mastitis : a series of 14 patients. Gynecological Endocrinology 2012; 28 (11): 921-924. doi: 10.3109/09513590.2012.683075
  • 7. Oran EŞ, Gürdal SÖ, Yankol Y, Öznur M, Calay Z et al. Management of idiopathic granulomatous mastitis diagnosed by core biopsy: a retrospective multicenter study. The Breast Journal 2013; 19 (4): 411-418. doi: 10.1111/tbj.12123
  • 8. Goldberg J, Baute L, Storey L, Park P. Granulomatous mastitis in pregnancy. Obstetrics and Gynecology 2000; 96 (5): 813- 815.
  • 9. Taylor GB, Paviour SD, Musaad S, Jones WO, Holland DJ. A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology 2003; 35 (2): 109-119.
  • 10. Al-Khaffaf B, Knox F, Bundred NJ. Idiopathic granulomatous mastitis : a 25-year experience. Journal of the American College of Surgeons 2008; 206 (2): 269-273. doi: 10.1016/j. jamcollsurg.2007.07.041
  • 11. Mahmodlou R, Dadkhah N, Abbasi F, Nasiri J, Valizadeh R. Idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment. Electronic Physician 2017; 9 (9): 5375-5379. doi: 10.19082/5375
  • 12. Ergin AB, Cristofanilli M, Daw H, Tahan G, Gong Y. Recurrent granulomatous mastitis mimicking inflammatory breast cancer. BMJ Case Reports 2011. doi:10.1136/bcr.07.2010.3156
  • 13. Uysal E, Soran A, Sezgin E, Granulomatous Mastitis Study Group. Factors related to recurrence of idiopathic granulomatous mastitis: what do we learn from a multicentre study? ANZ Journal of Surgery 2018; 88 (6): 635-639. doi: 10.1111/ans.14115
  • 14. Oltean HN, Soliman AS, Omar OS, Youssef TF, Karkouri M et al. Risk factors for chronic mastitis in Morocco and Egypt. International Journal of Inflammation 2013; 2013: 184921. doi: 10.1155/2013/184921
  • 15. Gautier N, Lalonde L, Tran-Thanh D, El Khoury M, David J et al. Chronic granulomatous mastitis : imaging , pathology and management. European Journal of Radiology 2013; 82 (4): e165-175. doi.org/10.1016/j.ejrad.2012.11.010
  • 16. Lai EC, Chan WC, Ma TK, Tang AP, Poon CS et al. The role of conservative treatment in idiopathic granulomatous mastitis. The Breast Journal 2005; 11 (6): 454-456.
  • 17. Troxell ML, Gordon NT, Doggett JS, Ballard M, Vetto JT et al. Cystic neutrophilic granulomatous mastitis: association with gram-positive bacilli and corynebacterium. American Journal of Clinical Pathology 2016; 145 (5): 635-645. doi: 10.1093/ ajcp/aqw046
  • 18. Bakaris S, Yuksel M, Ciragil P, Guven MA, Ezberci F et al. Granulomatous mastitis including breast tuberculosis and idiopathic lobular granulomatous mastitis. Canadian Journal of Surgery 2006; 49 (6): 427-430.
  • 19. Sheybani F, Sarvghad M, Naderi HR, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis. Obstetrics and Gynecology 2015; 125 (4): 801-807. doi: 10.1097/AOG.0000000000000734
  • 20. Su FH, Liu SC, Suen JH, Chen DS, Lou SMA. Idiopathic granulomatous mastitis: a case successfully treated with a minimum dose of a steroid. Chang Gung Medical Journal 2005; 28 (6): 431-435.
  • 21. Pathirana AA, Fernando A, de Silva MV. Three patients with granulomatous mastitis showing good response to oral prednisolone. The Ceylon Medical Journal 2007; 52 (1): 14-15.
  • 22. Kuba S, Yamaguchi J, Ohtani H, Shimokawa I, Maeda S et al. Vacuum-assisted biopsy and steroid therapy for granulomatous lobular mastitis: report of three cases. Surgery Today 2009; 39 (8): 695-699. doi: 10.1007/s00595-008-3891-7
  • 23. Hovanessian Larsen LJ, Peyvandi B, Klipfel N, Grant E, Iyengar G. Granulomatous lobular mastitis: imaging, diagnosis, and treatment. American Journal of Roentgenology 2009; 193 (2): 574-581.
  • 24. Azlina AF, Ariza Z, Arni T, Hisham AN. Chronic granulomatous mastitis: diagnostic and therapeutic considerations. World Journal of Surgery 2003; 27 (5): 515-518.
  • 25. Akbulut S, Arikanoglu Z, Senol A, Sogutcu N, Basbug M et al. Is methotrexate an acceptable treatment in the management of idiopathic granulomatous mastitis? Archives of Gynecology and Obstetrics 2011; 284 (5): 1189-1195. doi: 10.1007/s00404- 010-1825-2
  • 26. Raj N, Macmillan RD, Ellis IO, Deighton CM. Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology (Oxford) 2004; 43 (8): 1055-1056.
  • 27. Konan A, Kalyoncu U, Dogan I, Kılıç YA, Karakoç D et al. Combined long-term steroid and immunosuppressive treatment regimen in granulomatous mastitis. Breast Care (Basel) 2012; 7 (4): 297-301. doi: 10.1159/000341388
  • 28. Yılmaz TU, Gürel B, Güler SA, Baran MA, Erşan B et al. Scoring idiopathic granulomatous mastitis : an effective system for predicting recurrence? European Journal of Breast Health 2018; 14 (2): 112-116. doi: 10.5152/ejbh.2018.3709
  • 29. Baslaim MM, Khayat HA, Al-Amoudi SA. Idiopathic granulomatous mastitis: a heterogeneous disease with variable clinical presentation. World Journal of Surgery 2007; 31 (8): 1677-1681.
  • 30. Co M, Cheng VCC, Wei J, Wong SCY, Chan SMS et al. Idiopathic granulomatous mastitis: a 10-year study from a multicentre clinical database. Pathology 2018; 50 (7): 742-747. doi: 10.1016/j.pathol.2018.08.010
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

Surface enhanced Raman spectroscopy as a novel tool for rapid quantification of heroin and metabolites in saliva

Mahmut Şerif YILDIRIM, Necdet SAĞLAM, Hasan İLHAN, Ramazan AKÇAN, Uğur TAMER, Burcu GÜVEN

Statistical shape analysis of hand and wrist in paediatric population on radiographs

Semih BOLU, Ural KOÇ, Senem ÖZDEMİR, İlker ERCAN, Ayşegül YABACI, Onur TAYDAŞ

Correlation of language lateralization with resting state hippocampal connectivity in temporal lobe epilepsy patients

Ali Murat KOÇ, Murat UÇAR, Fatih ÖNCÜ, Ali Yusuf ÖNER, Halil ÖZER, Melike GÜRYILDIRIM, Emin Turgut TALI, Gökhan KURT, İrem ÇAPRAZ, Erhan BİLİR

Oxidative stress parameters in patients with ascending aortic dilatation

Salim NEŞELİOĞLU, Murat AKÇAY, Selçuk ÖZTÜRK, Melike POLAT, Muhammet Cihat ÇELİK, Yunus Emre ÖZBEBEK, Mehmet ERDOĞAN, Serdal BAŞTUĞ

Validity and reliability study of the Turkish version of the self-efficacy for managing chronic disease 6-item scale

Kübra İNCİRKUŞ, Nursen ÖZKAN NAHCİVAN

Association between monocyte to high-density lipoprotein cholesterol ratio and bicuspid aortic valve degeneration

Telat KELEŞ, Hüseyin AYHAN, Bilge DURAN KARADUMAN, Engin BOZKURT

A novel urethra compression technique using Turkish continence device for male urinary incontinence

İrem Gül SANCAK, Zerrin MAHMUT, Erkan ÖLÇÜCÜOĞLU, Sedat TAŞTEMUR, Yusuf KASAP, Neslihan ZENGİN, Öner ODABAŞ

Assessment of Ankaferd Blood Stopper in experimental liver ischemia reperfusion injury

Marlen SÜLEYMAN, Can ERSAK, Fatih KARAAHMET, Abdullah DURHAN, İlknur ALKAN KUŞABBİ, Mehmet ŞENES, Mesut TEZ, Eylem Pınar ESER, Sema HÜCÜMENOĞLU, Koray KOŞMAZ, Abdullah ŞENLİKCİ, Recep PEKÇİCİ, Yılmaz ÜNAL

Development of albumin macroinitiator for polymers to use in DNA origami coating

Ezgi EMÜL, Necdet SAĞLAM, Aykut BİLİR

Frequency of sarcopenia and associated outcomes in patients with chronic obstructive pulmonary disease

Ruhuşen KUTLU, Fatma Gökşin CİHAN, Havva DEMİRCİOĞLU, Adil ZAMANİ, Şebnem YOSUNKAYA