Yabanoğlu Hakan, Çolakoğlu Tamer, Belli Sedat, Aytac Huseyin Ozgur, Bolat Filiz Aka, Pourbagher Ayşin, Tezcaner Tugan, Yildirim Sedat, Haberal Mehmet
Department of General Surgery, Baskent University Faculty of Medicine, Adana, Turkey.
Department of Pathology, Baskent University Faculty of Medicine, Adana, Turkey.
Breast J. 2015 Jul-Aug;21(4):363-9. doi: 10.1111/tbj.12415. Epub 2015 Apr 10.
The purpose of this study was to analyze the clinical features and demographic data of patients with idiopathic granulomatous mastitis (IGM) and to compare the results of conservative versus surgical treatment protocols. The demographic data, clinical findings, microbiological and pathologic features, scanning and treatment methods, recurrence, and recovery rates of 77 patients were analyzed retrospectively. The patients were divided into two groups based on the type of treatment received. Core biopsies were used to diagnose 37 patients: 26 using incisional biopsies and 14 using excisional biopsies. Of the patient population with IGM, 31 were treated with surgical excision, one with a simple mastectomy, and one with a subcutaneous mastectomy combined with a breast implant, whereas 44 were treated with steroids. The recovery rates of the 44 patients who were treated conservatively were 6 (1-15) months while for the 33 patients who were treated surgically, it was 1 (1-5) month (p = 0.001). Nine patients from the conservative treatment group experienced a recurrence while there were no recurrences in the surgically treated group (p = 0.009). Among all patients, the recurrence rate was 11.7% (9/77) while the average follow-up period was 16.57 ± 18.57 months. As a comparative study between conservative treatment protocols and surgical ones for patients with idiopathic granulomatous mastitis (IGM), this study is the largest to date. A wide surgical excision is the preferred approach for treating patients with IGM because of the low recurrence rate.
本研究旨在分析特发性肉芽肿性乳腺炎（IGM）患者的临床特征和人口统计学数据，并比较保守治疗与手术治疗方案的结果。回顾性分析了77例患者的人口统计学数据、临床表现、微生物学和病理学特征、扫描及治疗方法、复发情况和恢复率。根据接受的治疗类型将患者分为两组。37例患者通过核心活检确诊：26例采用切开活检，14例采用切除活检。在IGM患者群体中，31例接受手术切除治疗，1例接受单纯乳房切除术，1例接受皮下乳房切除术并植入乳房假体，而44例接受类固醇治疗。保守治疗的44例患者的恢复时间为6（1 - 15）个月，而手术治疗的33例患者为1（1 - 5）个月（p = 0.001）。保守治疗组有9例患者复发，而手术治疗组无复发（p = 0.009）。在所有患者中，复发率为11.7%（9/77），平均随访期为16.57 ± 18.57个月。作为一项针对特发性肉芽肿性乳腺炎（IGM）患者的保守治疗方案与手术治疗方案的对比研究，本研究是迄今为止规模最大的。由于复发率低，广泛手术切除是治疗IGM患者的首选方法。
