Abstract
In this study we aimed to define clinical, radiologic and pathological specialties of patients who applied to General Surgery Department of Atatürk University Medical Faculty with granulomatous mastitis and show medical and surgical treatment results. With the help of this study we will be able to make our own clinical algorithm for diagnosis and treatment. We searched retrospectively addresses, phone numbers and clinical files of 93 patients whom diagnosed granulomatous mastitis between a decade of January 2001 - December 2010. We noted demographic specialties, ages, gender, medical family history, main complaints, physical findings, radiological and laboratory findings, medical treatments, postoperative complications and surgical procedures if they were operated; morbidity, recurrence and success ratios, complications after treatment for patients discussed above. In this study we evaluated 93 patients, 91 females and 2 males, with granulomatous mastitis retrospectively who applied to General Surgery Department of Atatürk University Medical Faculty between January 2001 and December 2010. Mean age was 34.4 years. The diagnosis was confirmed by histopathologic examination of the lesions. Seventy three patients had idiopathic granulomatous lobular mastitis and 20 patients had specific granulomatous mastitis IGM (18 tuberculosis mastitis, 1 alveolar echinococcosis and 1 silk reaction). All the patients had surgical debridement or antibiotic, and anti-inflammatory treatment with results bad clinical response before applied our clinic. Empiric antibiotic therapy and drainage of the breast lesions are not enough for complete remission of idiopathic granulomatous mastitis. The lesion must be excised completely. In selected patients, corticosteroid therapy can be useful. In the patients with tuberculous mastitis, abscess drainage and antituberculous therapy can be useful, but wide excision must be chosen for the patients with recurrent disease.
Highlights
Granulomatous mastitis (GM) is a rare benign disease of the breast, first described by Kessler and Wolloch in 1972 [1]
In the patients with tuberculous mastitis, abscess drainage and antituberculous therapy can be useful, but wide excision must be chosen for the patients with recurrent disease
Idiopathic GM is defined as GM without any other attributable causes and specific GM (SGM) can be a rare secondary complication of tuberculosis, sarcoidosis, Wegener’s granulomatosis, syphilis, corynebacterial infection, foreign body reaction, vasculitis, fungal and parasitic infections, etc. [2,3,4]
Summary
Granulomatous mastitis (GM) is a rare benign disease of the breast, first described by Kessler and Wolloch in 1972 [1]. It has two forms: Idiopathic GM (IGM) and specific GM (SGM). The primary presentation of GM is a firm breast mass, which is tender. The full presentation includes breast masses, tumorous indurations, skin ulcerations, inflammation, local pain, tenderness, galactorrhea, abscesses and fistulae. Many patients have a mass fixed to the skin or underlying structures and retraction of the nipple. In those situations, GM is confused with cancer. Pain and fever and they are regarded as nonspecific infection [5,6,7]
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