GRANULOMATOUS MASTITIS: PROBLEMS OF DIAGNOSIS AND TREATMENT

FARHAD KHORSHEED SULAYVANI; DILDAR HAJI MUSA; DELMAN YOUNIS OTHMAN

FARHAD KHORSHEED SULAYVANI Assistant Professor, Department of Surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
DILDAR HAJI MUSA Lecturer, Department of surgery, College of Medicine, University of Duhok, Kurdistan Region, Iraq.
DELMAN YOUNIS OTHMAN Azadi Teaching Hospital, Ministry of Health, Duhok, Kurdistan Region, Iraq.

Keywords: Granulomatous mastitis, ; diagnosis; management, complications

Abstract

https://doi.org/10.31386/dmj.uod.18.12.2.4

Background: Idiopathic granulomatous lobular mastitis (IGLM) is an uncommon non-specific inflammatory disease of the breast. The IGLM is a benign condition and it confuses the surgeons with cancer owing to its progressive breast lump. In the present study, the clinical characteristics, experiences of diagnosis, treatment, and outcomes of one and half year follow-up of 22 patients met the required histological criteria of idiopathic granulomatous lobular mastitis were examined and evaluated.

Subject and Methods: Between first November 2016 and 30^th April 2018, twenty two married, parous, non-smoker, and non-alcoholic patients diagnosed with IGLM with an average mean of 32.5 years (23-41 years old) were included in the study. The patients underwent breast ultrasonography for the clinical features following clinical examinations. The first choice of the diagnosis was the fine needle aspiration cytology (FNAC) and the false negative results were sent to the core needle biopsy (CNB) for the final confirmation. No patients underwent mammography and breast magnetic resonance imaging. The patients have received steroids following accomplishment of antibiotics time period. The incision and drainage were performed for the patients with mass or abscesses and were followed-up for one and half year to find out the response or recurrence.

Results: The study showed that mass, skin thickening, and pain were the most prevalent clinical features and abscess as the sign in patients with IGLM and their clinical characteristics were unilateral. Only 6 patients had given history of taking oral contraceptive. The common physical findings of clinical features and ultrasonographic finding were irregular hypoechoic mass and collection (20 cases); multiple (14 cases); with an abscess (11 cases). The same numbers of patients were diagnosed with FNAC and CNB. The patients received steroids therapy, underwent drainage and excision were 13, 13, and 9, respectively. Of the total patients, the lesions of 15 patients were healed and the recurrence rate was 31.8%.

Conclusions: The patients were diagnosed with IGLM and recruited in the present study responded to different therapeutic interventions and the healing rate was 68.2%.

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