School of Medicine, The University of Jordan, Amman, Jordan.
Division of Rheumatology, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, 11942, Jordan.
Rheumatol Int. 2023 Oct;43(10):1859-1869. doi: 10.1007/s00296-023-05375-6. Epub 2023 Jun 22.
Idiopathic Granulomatous Mastitis (IGM) is an infrequent, benign breast disease that primarily affects women during their childbearing years and can be mistaken for breast cancer. This study aimed to review the clinical, radiological, and histopathological findings of patients with IGM in addition to management and outcome. Retrospective cross-sectional study of biopsy-confirmed IGM at an academic medical center and a private hospital in Amman, Jordan. Fifty-four patients were included, with a mean age of 37.0 ± 9.04 years, mostly presenting with a breast lump (n = 52, 96.3%) and breast pain (n = 45 patients, 84.9%). Approximately half of the patients (51.9%) were parous, and 50% had breastfed for an average duration of 30.37 ± 22.38 months. Most of the patients had either solitary or multiple abscesses on breast ultrasound. Histopathological analysis (n = 35) showed mostly either moderate inflammation (n = 16, 45.7%) or severe inflammation (n = 14, 40%). Two-thirds of the patients underwent surgical interventions at the time of diagnosis, mostly incision and drainage (n = 16, 29%) or surgical excision (n = 7, 13%), and no mastectomies were performed. The most common medical treatment included a combination of antibiotics, corticosteroids, and methotrexate (n = 21, 38.8%). After follow-up, 31 patients remained in remission, 3 experienced relapses, and 3 had a chronic course. The use of corticosteroids was significantly associated with remission (p = 0.035). The presentation and demographics of IGM patients in Jordan were consistent with the existing literature. Prospective research is needed to explore different treatment options and disease outcomes.
特发性肉芽肿性乳腺炎(IGM)是一种罕见的良性乳腺疾病,主要影响生育期妇女,可能被误诊为乳腺癌。本研究旨在回顾性分析学术医疗中心和安曼一家私立医院活检证实的 IGM 患者的临床、放射影像学和组织病理学表现,以及管理和结局。在约旦安曼的一家学术医疗中心和一家私立医院进行了回顾性病例系列研究,纳入了经活检证实的 IGM 患者。共纳入 54 例患者,平均年龄为 37.0±9.04 岁,大多数以乳腺肿块(n=52,96.3%)和乳腺疼痛(n=45 例,84.9%)就诊。大约一半的患者(51.9%)已生育,50%的患者平均母乳喂养时长为 30.37±22.38 个月。大多数患者的乳腺超声检查显示有单发或多发脓肿。组织病理学分析(n=35)显示,大多数为中度炎症(n=16,45.7%)或重度炎症(n=14,40%)。三分之二的患者在诊断时接受了手术干预,最常见的是切开引流(n=16,29%)或手术切除(n=7,13%),未行乳房切除术。最常见的治疗方法是联合使用抗生素、皮质类固醇和甲氨蝶呤(n=21,38.8%)。随访后,31 例患者仍处于缓解期,3 例复发,3 例为慢性病程。皮质类固醇的使用与缓解显著相关(p=0.035)。约旦 IGM 患者的临床表现和人口统计学特征与现有文献一致。需要开展前瞻性研究以探索不同的治疗选择和疾病结局。