Retrospective Analysis of Idiopathic Granulomatous Mastitis: Its Diagnosis and Treatment

다국어 초록 (Multilingual Abstract)

Purpose: Idiopathic granulomatous mastitis (IGM) is a rare disease characterized by noncaseating granulomatous inflammation of unknown origin. Because its clinical features are similar to those of other type of mastitis or breast cancer, accurate diagnosis and adequate treatment are essential to ensuring a short symptom duration and improving the quality of life. Methods: The clinical, radiologic, pathophysiologic, and treatment data for 43 patients diagnosed with IGM at the Breast Cancer Center of Gachon University Gil Medical Center between 2005 and 2016 were retrospectively reviewed. Results: Forty-one patients (95.34%) were of childbearing age, seven (16.27%) had a history of lactation, and five (11.62%) had a history of oral contraceptive use. In terms of radiologic findings, 30 patients (69.77%) were diagnosed with Breast Imaging-Reporting and Data System category ≥4A lesions. Corticosteroid therapy was administered to 36 patients (83.72%); overall, 18 patients (41.86%) did not require surgery and 25 patients (58.13%) underwent partial or total mastectomy. Twelve patients (27.90%) developed recurrence. Conclusion: IGM is a benign disease that can be misdiagnosed as breast cancer because of its similar clinical and radiologic findings. Proper diagnosis and treatment can be difficult, but delays may lead to prolonged pain and cosmetic and socioeconomic problems. Efforts should be aimed at establishing the cause of IGM and developing efficient protocols for its diagnosis and treatment.

참고문헌 (Reference)

1 DeHertogh DA, "Prednisone management of granulomatous mastitis" 303 : 799-800, 1980

2 Davies JD, "Postpartum lobular granulomatous mastitis" 36 : 363-, 1983

3 Kim J, "Methotrexate in the management of granulomatous mastitis" 73 : 247-249, 2003

4 Imoto S, "Idiopathic granulomatous mastitis: case report and review of the literature" 27 : 274-277, 1997

5 Donn W, "Idiopathic granulomatous mastitis: a report of three cases and review of the literature" 118 : 822-825, 1994

6 Lin CH, "Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia" 7 : 2-, 2012

7 Fletcher A, "Granulomatous mastitis: a report of seven cases" 35 : 941-945, 1982

8 Kessler E, "Granulomatous mastitis: a lesion clinically simulating carcinoma" 58 : 642-646, 1972

9 Bakaris S, "Granulomatous mastitis including breast tuberculosis and idiopathic lobular granulomatous mastitis. Can J Surg 2006;49:427-30. 12 Akcan A, Akyildiz H, Deneme MA, Akgun H, Aritas Y. Granulomatous lobular mastitis: a complex diagnostic and therapeutic problem" 30 : 1403-1409, 2006

10 Goldberg J, "Granulomatous mastitis in pregnancy" 96 (96): 813-815, 2000

11 Osborne BM, "Granulomatous mastitis caused by histoplasma and mimicking inflammatory breast carcinoma" 20 : 47-52, 1989

12 Rowe PH, "Granulomatous mastitis associated with a pituitary prolactinoma" 38 : 32-34, 1984

13 Hovanessian Larsen LJ, "Granulomatous lobular mastitis: imaging, diagnosis, and treatment" 193 : 574-581, 2009

14 Jorgensen MB, "Diagnosis and treatment of granulomatous mastitis" 93 : 97-101, 1992

15 Taylor GB, "A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis" 35 : 109-119, 2003