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Federación Mexicana de Ginecología y Obstetricia, A.C.

2020, Number 09

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Ginecol Obstet Mex 2020; 88 (09)

Idiopathic granulomatous mastitis: demographic, clinical and imaging characteristics of a series of cases

Pérez-Velázquez EI, Espinosa-Valencia KM, Rosas-Baldazo D, Ibarra-Patiño R

Language: Spanish
References: 27
Page: 598-605
PDF size: 211.49 Kb.


ABSTRACT

Objective: To perform a demographic, clinical and imaging characterization of a series of cases of idiopathic granulomatous mastitis.
Materials and Methods: Observational, retrospective and cross-sectional study of a series of cases of patients diagnosed with idiopathic granulomatous mastitis, at Hospital Universitario “Dr. José Eleuterio González in Monterrey, Mexico between January 2015 and December 2019. The study comprised all patients older than 18 years old who had histological diagnosis of idiopathic granulomatous mastitis in the absence of a specific agent. Patients with mastitis related to a specific pathology or with a history of recent breast trauma/laceration were excluded. Variables to determine are demographic information (age, education, marital status, etc.), diagnostic process/ method, imaging findings and treatment.
Results: 20 patients with an average age of 32 years were included, 17 of childbearing age, and the rest at menopause. All patients had at least one full-term pregnancy and a variable lactation period. 19 presented the disease unilaterally, 60% in the left breast. Clinical presentation: 20 presented tumor, 15 erythema and 11 mastalgia. Imaging: BIRADS IVA in 12, IVB in 6 , III in 1 and II in 1. Diagnostic confirmation was performed in all patients by histopathological study. 12 received initial treatment with prednisone, 7 with antibiotics and NSAIDs, and one case with surgical excision.
Conclusions: Idiopathic granulomatous mastitis is a rare benign and chronic inflammatory disease of unknown prevalence and pathogenesis. It mainly affects women of reproductive age. Imaging studies usually report nonspecific findings. It requires histopathological study to establish a definitive diagnosis, as it is a disease with diagnosis by exclusion, ideally by taking a Tru-cut biopsy. Although several therapeutic alternatives have been proposed, currently there is no universal protocol for treatment, however, resection of the lesion with wide margins associated or not with oral corticosteroids prevails as the most widely used treatment nowadays.


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