Department of Surgery, Haydarpasa Numune Teaching and Research Hospital, Istanbul, Turkey.
J Breast Cancer. 2012 Mar;15(1):119-23. doi: 10.4048/jbc.2012.15.1.119. Epub 2012 Mar 28.
Idiopathic granulomatous lobular mastitis (IGLM) is a rare chronic inflammatory disease of the breast with obscure etiology that mimics invasive carcinoma both clinically and radiologically. The treatment of IGLM remains controversial. The aim of proper management is to use a combination of medical and surgical treatment of this benign condition to achieve a good cosmetic result and low recurrence rate.
A retrospective analysis of 19 patients with IGLM is performed based on the findings of clinical, radiological, and pathological examinations. The results of two treatments are presented: medical treatment with oral corticosteroids, and consecutive surgical excision after a follow-up period of 20 months (range, 6-75 months).
The majority of patients treated in this paper were young (mean, 34 years) parous women with a history of hormonal medication use. The main clinical finding is large, irregular, and painful mass. Hypoechoic lobulated, irregular tubular or oval shaped masses had been imaged by ultrasound. Mammographic findings were an ill-defined mass, enlarged axillary lymph nodes, asymmetric density, and architectural distortion. Diagnoses of IGLM had been established by cytological or histological examination. Symptoms subside and inflammatory changes regressed with medical treatment. The remaining lesions were excised by consecutive breast conserving surgery. The disease recurred in one patient during the follow-up period.
IGLM is an inflammatory breast disease found in young women who present with a large painful irregular mass, which mimics carcinoma, as a physical change. Breast imaging modalities are not helpful to differentiate IGLM from invasive cancer. The correct diagnosis is established by cytological or histological examination. Medical treatment with corticosteroids provides significant regression of the inflammatory disease, allowing more conservative surgery. Consecutive surgical excision of the remaining lesions with good cosmetic results provides definitive treatment and reduces the risk of recurrence.
特发性肉芽肿性小叶性乳腺炎（IGLM）是一种罕见的乳腺慢性炎症性疾病，病因不明，在临床和影像学上均类似于浸润性癌。IGLM 的治疗仍存在争议。适当治疗的目的是通过联合使用药物和手术治疗这种良性疾病，以达到良好的美容效果和低复发率。
对 19 例 IGLM 患者的临床、影像学和病理学检查结果进行回顾性分析。报告了两种治疗方法的结果：口服皮质类固醇的药物治疗，以及在 20 个月（6-75 个月）的随访期后连续手术切除。
本文治疗的大多数患者为年轻（平均 34 岁）经产妇女，有激素药物使用史。主要的临床发现是大的、不规则的、疼痛的肿块。超声检查显示低回声分叶状、不规则管状或椭圆形肿块。乳腺 X 线照相的发现是一个边界不清的肿块、腋窝淋巴结肿大、不对称密度和结构扭曲。通过细胞学或组织学检查确立了 IGLM 的诊断。症状随着药物治疗而缓解，炎症改变消退。剩余的病变通过连续的保乳手术切除。在随访期间，1 例患者疾病复发。
IGLM 是一种发生在年轻女性中的炎症性乳腺疾病，表现为大的、疼痛的、不规则的肿块，与癌症的物理变化相似。乳腺成像方式无助于将 IGLM 与浸润性癌区分开来。通过细胞学或组织学检查可明确诊断。皮质类固醇的药物治疗可显著缓解炎症性疾病，使更保守的手术成为可能。对剩余病变进行连续手术切除，可获得良好的美容效果，提供明确的治疗，并降低复发风险。
