Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
Department of Pathology, University of Chicago Pritzker School of Medicine, Chicago, IL, 60637, USA.
Mil Med Res. 2022 Apr 26;9(1):20. doi: 10.1186/s40779-022-00380-5.
Granulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.
肉芽肿性小叶性乳腺炎（GLM）是一种罕见的、慢性的良性乳腺炎症性疾病。对于许多一线外科医生和医疗专家来说，GLM 的治疗存在困难，他们负责治疗患有乳腺炎症性疾病的患者。本共识旨在为 GLM 的管理制定基于证据的推荐意见。使用 PubMed 从 1971 年 1 月 1 日至 2020 年 7 月 31 日对文献进行了回顾。邀请了来自 11 个国家或地区的 66 名具有国际经验的多学科专家对证据进行审查。使用美国医师学院的分级系统确定证据水平，并进行讨论直到达成共识。专家们对 GLM 的历史定义、病因和易患因素、诊断标准、治疗、临床分期、复发和再发进行了讨论并达成了 30 项建议。GLM 被推荐作为一个广泛接受的定义。此外，本共识还为 GLM 引入了新的临床分期和管理算法，以提供个体化的治疗策略。总之，GLM 的诊断取决于病史、临床表现、影像学检查、实验室检查和病理学的综合评估。GLM 的治疗方法应根据其不同的临床分期进行选择。本基于证据的共识将有助于一线外科医生和医疗专家对 GLM 进行最佳管理。
