Oncoplastic breast surgery to treat recurrent granulomatous abscess: A new approach.

Mohamed Aymen Ferjaoui,Henda Mustapha,Monia Malek,Khaled Neji,Slim Khedhri,Ramzi Arfaoui

doi:10.1016/j.ijscr.2021.106440

Abstract

Introduction and importanceGranulomatous mastitis is a rare chronic and benign inflammatory breast disease with challenging diagnosis and management. No commonly recognized recommendations are established. Despite of medical and surgical approaches, relapse rate remains high.Case presentationA 43-year-old patient with a history of granulomatous mastitis presented recurrent breast abscess associated with skin fistula. She underwent Racquet mammoplasty procedure inspired from oncoplastic techniques. Medical and cosmetic outcomes were satisfactory.Clinical discussionGranulomatous mastitis is challenging to diagnose and can be confused with inflammatory breast malignancies. It's associated with high relapse rate. Management of granulomatous mastitis is complex. Its treatment varies from medical management based on steroid therapy and immunosuppressants to surgical approach. In case of recurrent breast abscess, surgical techniques inspired from oncoplastic breast surgery, can be used to improve cosmetic outcome.ConclusionOncoplastic surgical technic may be considered as an efficient procedure to manage recurrent breast granulomatous abscess.

Highlights

Introduction and importanceGranulomatous mastitis is a rare chronic and benign inflammatory breast disease with challenging diagnosis and management
Surgical techniques inspired from oncoplastic breast surgery, can be used to manage recurrent breast ab scess [5,6]
We report a case of recurrent breast abscess with a skin fistula in a patient with history of granulomatous mastitis

Summary

Introduction

Granulomatous mastitis is a rare benign inflammatory breast disease. This is a chronic condition with unknown etiology affecting usually young women. Aesthetic and cosmetic outcome after surgical excision remains poor and unsatisfactory because of important local inflammatory reaction and wide tissue resection. It impacts negatively on patient's self-imaging and leads to psychologic disorders. Surgical techniques inspired from oncoplastic breast surgery, can be used to manage recurrent breast ab scess [5,6]. We report a case of recurrent breast abscess with a skin fistula in a patient with history of granulomatous mastitis. This case report aims to explain how to perform Racquet mammo plasty surgical technique and to assess its usefulness to decrease abscess relapse rate and to preserve cosmetic outcome. The work has been reported in line with the SCARE criteria [7]

Case report

Discussion

Conclusion

Ethical approval