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肉芽肿性乳腺炎的随访:监测与手术对比

Follow-up of granulomatous mastitis with monitoring versus surgery.

作者信息

Calis Hasan, Karabeyoglu Serif Melih

出版信息

Breast Dis. 2017;37(2):69-72. doi: 10.3233/BD-160259.

Abstract

BACKGROUND

IGM (Idiopathic Granulomatous Mastitis) is a rare, chronic, non-malignant and non-life-threatening breast disease. Clinically and radiologically, it has similar characteristics with other granulomatous diseases and breast carcinomas.

METHODS

The patients whom diagnosed IGM according to pathology report were retrospectively evaluated between November 2014 and January 2016. The demographic properties, complaints during admission, diagnosis and treatment methods and clinical results were obtained via investigation of the patient files. The patients were called for follow-up and discussion.

RESULTS

The patients whom diagnosed IGM were retrospectively evaluated and total number of patients were 19. The average following period was 11 months (4-13 months). Fourteen patients were in the reproductive period, five patients were in the postmenopausal period. Ultrasound imaging was performed on all patients, mammography was done on 6 patients over 40 years of age. The patients were not imaged by magnetic resonance imaging (MRI). Sixteen patients had IGM in a single breast, only three patient have an IGM history in bilateral breast, one or three years ago. Core biopsy was performed on all patients. One patient with bilateral IGM diagnosis performed a drainage and incisional biopsy due to a twice developing abscess clinic and recurrence. One patient had final diagnosis coexistence IGM and ductal carcinoma.

CONCLUSIONS

Patients who followed-up by observation should be explained that IGM is a chronic disease and that it may recur in certain periods. Clinical, radiological and pathological examinations should be performed together for breast cancer developing due to the chronical progresses of IGM or concurrent breast cancer.

摘要

背景

特发性肉芽肿性乳腺炎(IGM)是一种罕见的、慢性的、非恶性且不危及生命的乳腺疾病。在临床和放射学方面,它与其他肉芽肿性疾病及乳腺癌具有相似特征。

方法

对2014年11月至2016年1月间根据病理报告确诊为IGM的患者进行回顾性评估。通过查阅患者病历获取其人口统计学特征、入院时的主诉、诊断和治疗方法以及临床结果。对患者进行随访并讨论。

结果

对确诊为IGM的患者进行回顾性评估,患者总数为19例。平均随访期为11个月(4 - 13个月)。14例患者处于生育期,5例患者处于绝经后期。所有患者均进行了超声检查,40岁以上的6例患者进行了乳腺钼靶检查。患者均未进行磁共振成像(MRI)检查。16例患者单侧乳房患有IGM,仅3例患者曾在1至3年前双侧乳房有IGM病史。所有患者均进行了粗针活检取芯。1例双侧IGM诊断患者因脓肿两次发作及复发进行了引流和切开活检。1例患者最终诊断为IGM与导管癌并存。

结论

对于采用观察随访的患者,应向其解释IGM是一种慢性病,且可能在某些时期复发。由于IGM的慢性进展或并发乳腺癌,应同时进行临床、放射学和病理学检查以排查乳腺癌。

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