Prasad Seetharam, Jaiprakash Padmapriya, Dave Aniket, Pai Deepti
Department of General Surgery, Kasturba Medical College, Manipal, India.
Department of Pathology, Kasturba Medical College, Manipal, India.
Turk J Surg. 2017 Jun 1;33(2):100-103. doi: 10.5152/turkjsurg.2017.3439. eCollection 2017.
To study idiopathic granulomatous mastitis with respect to its various clinical features, etiologic factors, treatment modalities and complications.
Retrospective study of all patients who were diagnosed with idiopathic granulomatous mastitis from 1 January 2006 to 31 December 2014 at Kasturba Hospital, Manipal, India (a tertiary care referral centre). The research was performed according to the World Medical Association Declaration of Helsinki. Informed consent was taken from the patient before invasive procedures including surgery. Data was analysed using the Statistical Package for Social Sciences version 16.0 wherever appropriate.
73 patients diagnosed with idiopathic granulomatous mastitis during the time period were included. One patient was a male (1.37%), rest were all females (98.63%). The mean age of presentation was 32.67 years (range 23 to 66 years). 70 patients (95.89%) were parous females. Average duration since last childbirth was 4.6 years (range: 3 months to 33 years). 8 patients (10.95%) were lactating. History of oral contraceptive pill use was present in 40 patients (54.79%). The right breast was affected in 44 patients (60.27%), and the left breast in 29 patients (39.73%). None of the patients had bilateral disease. The most common symptom was a painless lump (61.64%). Rest of the patients (38.36%) presented with features of a breast abscess. 19 out of 39 FNACs done (48.72%) were positive for granulomatous mastitis. 59 were primarily managed surgically (lumpectomy/wide excision-33, incision & drainage-26). One patient was treated primarily with prednisolone. 13 patients did not receive specific treatment, and were only kept on regular follow-up. Patients managed with lumpectomy/wide excision had the least rate of complications & recurrence (18.18%).
Patients with idiopathic granulomatous mastitis can present with a wide variety of symptoms which mimic other more common conditions. Surgical management in the form of wide excision appears to provide the best long term outcome in patients with idiopathic granulomatous mastitis.
研究特发性肉芽肿性乳腺炎的各种临床特征、病因、治疗方式及并发症。
对2006年1月1日至2014年12月31日在印度马尼帕尔卡斯图尔巴医院（一家三级医疗转诊中心）被诊断为特发性肉芽肿性乳腺炎的所有患者进行回顾性研究。本研究按照世界医学协会《赫尔辛基宣言》进行。在包括手术在内的侵入性操作前，已获得患者的知情同意。在适当情况下，使用社会科学统计软件包第16.0版对数据进行分析。
纳入了在此期间被诊断为特发性肉芽肿性乳腺炎的73例患者。1例为男性（1.37%），其余均为女性（98.63%）。就诊时的平均年龄为32.67岁（范围23至66岁）。70例患者（95.89%）为经产妇。自上次分娩后的平均时长为4.6年（范围：3个月至33年）。8例患者（10.95%）正在哺乳。40例患者（54.79%）有口服避孕药史。44例患者（60.27%）右侧乳房受累，29例患者（39.73%）左侧乳房受累。所有患者均无双侧病变。最常见的症状是无痛性肿块（61.64%）。其余患者（38.36%）表现为乳腺脓肿的特征。39例细针穿刺抽吸活检（FNAC）中有19例（48.72%）肉芽肿性乳腺炎呈阳性。59例主要接受手术治疗（肿块切除术/广泛切除术 - 33例，切开引流 - 26例）。1例患者主要接受泼尼松龙治疗。13例患者未接受特殊治疗，仅进行定期随访。接受肿块切除术/广泛切除术治疗的患者并发症及复发率最低（18.18%）。
特发性肉芽肿性乳腺炎患者可表现出多种类似于其他更常见病症的症状。广泛切除形式的手术治疗似乎为特发性肉芽肿性乳腺炎患者提供了最佳的长期治疗效果。
