Department of General Surgery Medical Faculty of Mersin University, Mersin, Turkey.
Breast J. 2010 Mar-Apr;16(2):176-82. doi: 10.1111/j.1524-4741.2009.00879.x. Epub 2009 Dec 16.
This clinical study was conducted to present clinical, radiologic, and histopathologic features of Granulomatous Mastitis (GM) and evaluate the result of surgical and steroid treatment. Sixteen cases diagnosed histologically as GM were reviewed. Patient characteristics, clinical presentation, radiologic imaging, microbiologic, histopathologic assessment, treatment modalities, recurrence, morbidity, and follow-up data were analyzed. Majority of the patients were child bearing age and all of the patients had a history of breast feeding. Radiologic findings were nonspecific. Histopathology showed the characteristic distribution of granulomatous inflammation in all cases. In 12 cases, surgical excision of the lesion with negative margins was performed. Four cases required quadranectomy because of wideness of the disease. Three patients who had local reoccurrence and three resistant patients were treated by oral prednisone after surgical attempt. Complete remission was obtained and no further recurrence was observed in this patients. GM predominantly occurs in premenopausal women and the clinical symptoms might be misjudged as breast cancer. Histopathologic examination remains the gold standard for the diagnosis. Wide excision of the lesions is the recommended therapy and we suggest steroid therapy in resistant or recurrent disease following the idea that the disease has an autoimmune component.
本临床研究旨在介绍肉芽肿性乳腺炎（GM）的临床、放射学和组织病理学特征，并评估手术和类固醇治疗的结果。回顾了 16 例经组织学诊断为 GM 的病例。分析了患者特征、临床表现、放射影像学表现、微生物学、组织病理学评估、治疗方式、复发、发病率和随访数据。大多数患者处于生育年龄，所有患者均有哺乳史。放射学表现不具特异性。组织病理学显示所有病例均存在特征性的肉芽肿性炎症分布。在 12 例病例中，采用边缘阴性的手术切除病变。由于疾病范围较宽，4 例需要行象限切除术。3 例局部复发和 3 例耐药患者在手术尝试后接受口服泼尼松治疗。所有患者均获得完全缓解，未再复发。GM 主要发生在绝经前妇女，其临床症状可能被误诊为乳腺癌。组织病理学检查仍然是诊断的金标准。建议广泛切除病变，对于耐药或复发的患者，我们建议根据疾病具有自身免疫成分的观点，采用类固醇治疗。
