Outcomes from treatment of Granulomatous lobular mastitis

•93% of patients were Hispanic. 4% had autoimmune diseases.•Aspiration of fluid collections was preferred. Avoid steroids and surgery.•Duration of disease was 19–33.5 weeks. Recurrence rate was 24%. Granulomatous lobular mastitis (GLM) is an uncommon benign breast condition characterized by non-case...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Surgery in practice and science 2021-12, Vol.7, p.100045, Article 100045
Hauptverfasser: Olimpiadi, Yuliya B., Brownson, Kirstyn E., Ding, Li, Sener, Stephen F.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
Beschreibung
Zusammenfassung:•93% of patients were Hispanic. 4% had autoimmune diseases.•Aspiration of fluid collections was preferred. Avoid steroids and surgery.•Duration of disease was 19–33.5 weeks. Recurrence rate was 24%. Granulomatous lobular mastitis (GLM) is an uncommon benign breast condition characterized by non-caseating Granulomatous inflammation arising from the lobules of the breast. Current therapeutic options include observation, percutaneous aspiration, antibiotics, steroids, methotrexate, and surgical procedures. This study evaluated the effectiveness of therapeutic modalities on the duration of disease and recurrence rate. A retrospective analysis was performed of clinical, radiographic, and therapeutic data for patients presenting with GLM from January 2008 until October 2018. All patients had a core breast biopsy demonstrating granulomas. Patients with other known sources of granulomas were identified. The use of observation, steroids, methotrexate, abscess aspiration, and surgical procedures was evaluated. There were 285 female patients, predominantly Hispanic (n = 265, 93%) with mean age of 35.6 ± 8.7 years at time of diagnosis. The majority of patients (n = 213, 75%) presented with a mass, mean size 4.2 ± 2.5 cm. Twelve (4%) patients had coexisting autoimmune diseases. Antibiotics were utilized in 217 (76%) patients for courses that averaged 3.4 ± 2.2 weeks. Glucocorticoids were used in 80 (28%) patients, and methotrexate was used in 16 (5%). Incision and drainage or surgical excision was performed for 76 (27%) of patients. The median duration of disease was 16 (IQR: 7–33) weeks and the overall recurrence rate was 22%. Both duration of disease and recurrence rate were highest amongst patients treated with a surgical intervention. The self-limited course of disease and relatively low recurrence rate, in addition to longer disease duration and increased recurrence rate noted in patients treated with incision and drainage and/or surgical excision, appears to justify the infrequent use of surgical procedures in the management of GLM.
ISSN:2666-2620
2666-2620
DOI:10.1016/j.sipas.2021.100045