Ultrasound classification-guided minimally invasive rotary cutting in granulomatous lobular mastitis
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RESEARCH ARTICLE
Ultrasound classification‑guided minimally invasive rotary cutting in granulomatous lobular mastitis Hongye Liao, Jujiang Guo, Xuming Chen, Zhipeng Hua, Juli Lin and Yiyin Weng*
Abstract Background: To summarize the clinical experience of ultrasound-guided minimally invasive surgery for granulomatous lobular mastitis (GLM), and explore the feasibility of this technique for treating GLM. Methods: This retrospective study reviewed the clinical features and treatment outcome of 30 patients who were diagnosed pathologically as GLM from 2016.3 to 2019.5 in the Department of Breast Surgery, Women’s and Children’s Hospital, Xiamen University. These patients weretreated with ultrasound-guided Mammotome minimally invasive surgery, and we tried to classified the lesion into four distinct patterns (diffuse abscess mixed type, sheet hypoechoic type, localized abscess type, localized hypoechoic mass type) according to the sonographic findings and clinical symptoms to find out if these patterns correlated with treatment and recurrence rate. Results: After a median follow-up of 12 months on average (4–42 months), 26 cases (86.7%) were cured without acute or chronic complications such as disseminated inflammation and bleeding. Post-operative bleeding occurred in 1 case, and 3 cases (10.00%) relapsed. The ultrasound classification had 0 cases of diffuse abscess mixed type, 17 cases (56.7%) of sheet hypoechoic type, 9 cases (30%) of localized abscess type, and 4 cases (13.3%) of localized hypoechoic mass type. All 3 recurrent cases were sheet hypoechoic type, which were cured after another open surgical resection and showed no recurrence during an average follow-up of 20 months (11–40 months). Conclusions: In treating GLM patients with minimally invasive rotary cutting, ultrasound classification helps to select suitable patients, especially those with localized abscess and localized hypoechoic mass types with low recurrence rate, which is one of the safe and effective treatment methods. Keywords: Mammotome minimally invasive rotary cutting technology, Granulomatous lobular mastitis (GLM), Ultrasonography classification, Esthetic outcomes Background Granulomatous lobular mastitis (GLM) is a chronic nonspecific inflammatory disease, limited to the lobules of the breast tissue, with the main pathological characteristic of necrotizing granuloma [1]. It is a rare, benign condition of the breast with poorly understood etiology, *Correspondence: [email protected] Department of Breast Surgery, Women and Children’s Hospital, School of Medicine, Xiamen University, No. 10 Zhenhai Road, Xiamen 361000, Fujian, China
unpredictable duration, and lack of consensus about optimal treatment. It mainly occurs in post-pregnant and non-lactating young and middle-aged women. The common clinical manifestations include non-cyclic breast pain, nipple discharge, inverted nipple, breast lumps, non-lactating breast abscess, cutaneous fistula, etc. Similarities with other diseases clinically and radiographically can lead
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