Granulomatous mastitis, watch and wait is a good option
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ORIGINAL ARTICLE
Granulomatous mastitis, watch and wait is a good option Gökay Çetinkaya 1
&
Ramazan Kozan 1
&
Ahmet Cihangir Emral 1
&
Ekmel Tezel 1
Received: 18 September 2020 / Accepted: 15 October 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background Idiopathic granulomatous mastitis (IGM) is a benign and rare chronic inflammatory disease of the breast with unknown etiology. While there is no consensus regarding its post-diagnosis management, there are different treatment alternatives. Aims In this study, it was aimed to question the effectiveness of follow-up strategy without administering any treatment. Methods One hundred eighteen female patients diagnosed with IGM were retrospectively evaluated. Patients with histopathologically confirmed IGM were included in the study. Medical treatment was given only to patients who did not accept the follow-up option without treatment. The protocol used in steroid therapy was 16 mg prednisolone twice daily for 2 weeks, and then the dose was gradually reduced, and the treatment was stopped after 2 months. Patients were followed up with a physical examination every 3 months. The effectiveness of the systemic corticosteroid treatment and the follow-up approach without any treatment was compared. The recurrence rates and pre-treatment and post-treatment methods of the patients were examined. Results While 30.5% of the patients recovered with corticosteroid treatment, 42.4% recovered under observation without any treatment. The mean recovery period of the patients in these two groups was calculated as 3.9 months and 5.6 months, respectively. However, no statistically significant difference was found in terms of recovery period (p = 0.064). The recurrence rate was 11.9%. Conclusion For IGM, the “watch and wait” approach is an effective option. A chance should be given to the self-limiting nature of the disease with the addition of drainage when necessary. Keywords Corticosteroid . Granulomatous mastitis . Observation . Recurrence . Therapy
Introduction Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of the breast with unknown etiology. It is an important clinical problem due to various reasons such as the ability to imitate breast cancer and the difficulties in its management [1, 2]. While the main underlying cause is not known, some inflammatory, infectious, and hormonal factors are thought to be triggers [3]. The disease is frequently seen in premenopausal women. The clinical spectrum is highly extensive, and local or diffuse involvement can be observed. Patients are frequently admitted with painful, palpable mass
* Ramazan Kozan [email protected] 1
Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
or induration accompanied by skin or nipple retraction. The mass in the breast can become complicated with abscess and fistula formation [2, 4–6]. Its clinic is similar to inflammatory breast cancer and radiologically brings along the suspicion of malignancy characteristically [1, 2, 5]
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