Freeman C M, Xia B T, Wilson G C, Lewis J D, Khan S, Lee S J, Lower E E, Edwards M J, Shaughnessy E A
Department of Surgery, Division of Surgical Oncology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Department of Pathology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Am J Surg. 2017 Oct;214(4):701-706. doi: 10.1016/j.amjsurg.2017.07.002. Epub 2017 Jul 8.
Idiopathic granulomatous mastitis is a rare benign breast disease of women of reproductive age. It usually presents as a painful mass. Since the etiology is unclear, directed diagnosis and management is lacking.
This is a retrospective chart review of 14 patients, over twelve years (2004-2016), identified through query of pathology findings.
Two asymptomatic patients were diagnosed after oncologic breast resection following neoadjuvant chemotherapy. The remaining twelve patients were young (31.7 years, range 23-43 years), predominantly non-white (50% African/African-American, 36% Hispanic, 7% Asian), pregnant within the last five years (86%), with no prior granulomatous disease. Evaluation included breast imaging, microbial cultures and staining, and biopsy. Treatment included antibiotics (57%), corticosteroids (21%), methotrexate (7%), and/or surgery (71%). Imaging suggests segmental masses, possibly abscess.
Granulomatous mastitis is uncommon, and difficult to diagnose and manage. We review our experience, the literature, and propose an algorithm for diagnosis and management.
特发性肉芽肿性乳腺炎是一种发生于育龄女性的罕见良性乳腺疾病。通常表现为疼痛性肿块。由于病因不明，缺乏针对性的诊断和治疗方法。
这是一项回顾性病历审查，通过查询病理结果，对14例患者进行了为期十二年（2004 - 2016年）的研究。
两名无症状患者在新辅助化疗后接受肿瘤性乳腺切除术后被诊断出来。其余十二名患者较为年轻（平均31.7岁，范围23 - 43岁），主要为非白人（50%为非洲裔/非裔美国人，36%为西班牙裔，7%为亚裔），在过去五年内有过怀孕经历（86%），且既往无肉芽肿性疾病史。评估包括乳腺影像学检查、微生物培养及染色以及活检。治疗方法包括使用抗生素（57%）、皮质类固醇（21%）、甲氨蝶呤（7%）和/或手术（71%）。影像学检查提示节段性肿块，可能为脓肿。
肉芽肿性乳腺炎并不常见，诊断和治疗都很困难。我们回顾了我们的经验及相关文献，并提出了一种诊断和治疗方案。
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