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特发性肉芽肿性乳腺炎:六年的经验和目前文献中的证据。

Idiopathic Granulomatous Mastitis: Six years of experience and the current evidence in literature.

机构信息

Department of General Surgery, Oman Medical Specialty Board, Muscat, Oman.

Department of Surgery, The Royal Hospital, Muscat, Oman.

出版信息

Sultan Qaboos Univ Med J. 2023 Feb;23(1):36-41. doi: 10.18295/squmj.4.2022.030. Epub 2023 Feb 23.

Abstract

OBJECTIVES

This study aimed to retrospectively describe the clinicopathological pattern and management experience of idiopathic granulomatous mastitis in women receiving care at the Royal Hospital, a tertiary care centre in Oman. The study then compared the researchers' experience with the current literature trends.

METHODS

The data of patients from January 2012 to December 2017 were reviewed retrospectively, after receiving ethical approval from the Centre of Studies and Research.

RESULTS

This retrospective study included 64 patients were confirmed to have idiopathic granulomatous mastitis. All patients were in the premenopausal phase, with only one being nulliparous. Mastitis was the most common clinical diagnosis; furthermore, half of the patients had a palpable mass. Most patients had received antibiotics during the span of their treatment. Drainage procedure was done in 73% of the patients, whereas excisional procedure was done for 38.7%. Only 52.4% of patients were able to achieve complete clinical resolution within six months of follow-up.

CONCLUSION

There is no standardised management algorithm due to the paucity of high-level evidence comparing different modalities. However, steroids, methotrexate and surgery are all considered to be effective and acceptable treatments. Moreover, current literature tends towards multimodality treatments planned tailored case-to-case based on the clinical context and patients' preference.

摘要

目的

本研究旨在回顾性描述在阿曼三级护理中心皇家医院就诊的女性特发性肉芽肿性乳腺炎的临床病理模式和治疗经验,并将研究人员的经验与当前文献趋势进行比较。

方法

在获得研究中心的伦理批准后,回顾性分析了 2012 年 1 月至 2017 年 12 月期间的患者数据。

结果

本回顾性研究共纳入 64 例经病理证实为特发性肉芽肿性乳腺炎的患者。所有患者均处于绝经前阶段,仅有 1 例为未婚未育。乳腺炎是最常见的临床诊断;此外,一半的患者有可触及的肿块。大多数患者在治疗过程中接受了抗生素治疗。73%的患者接受了引流手术,38.7%的患者接受了切除术。只有 52.4%的患者在随访 6 个月内能够完全临床缓解。

结论

由于缺乏比较不同治疗方法的高级别证据,因此没有标准化的管理算法。然而,类固醇、甲氨蝶呤和手术都被认为是有效和可接受的治疗方法。此外,当前的文献倾向于根据临床情况和患者偏好,针对每个病例制定个体化的多模态治疗方案。

相似文献

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Idiopathic granulomatous mastitis: experience at a New York hospital.特发性肉芽肿性乳腺炎:纽约一家医院的经验。
Ann R Coll Surg Engl. 2022 Jul;104(7):543-547. doi: 10.1308/rcsann.2021.0239. Epub 2021 Nov 23.

本文引用的文献

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Cystic neutrophilic granulomatous mastitis: an update.囊性中性粒细胞性肉芽肿性乳腺炎:更新。
J Clin Pathol. 2020 Aug;73(8):445-453. doi: 10.1136/jclinpath-2019-206180. Epub 2020 Feb 24.
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Histopathologic review of granulomatous inflammation.肉芽肿性炎症的组织病理学检查
J Clin Tuberc Other Mycobact Dis. 2017 Feb 10;7:1-12. doi: 10.1016/j.jctube.2017.02.001. eCollection 2017 May.

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