Emergency Department, Instituto Nacional Materno Perinatal, Lima, Peru.
School of Medicine "San Fernando." Universidad Nacional Mayor de San Marcos, Lima, Peru.
Rev Bras Ginecol Obstet. 2023 Jun;45(6):319-324. doi: 10.1055/s-0043-1770089. Epub 2023 Jul 21.
Reporting our experience of the management and treatment of Idiopathic granulomatous mastitis (IGM) in a low-income country by describing patients characteristics and therapy with emphasis on conservative surgical excision and postoperative care as the cornerstone of treatment.
A retrospective cohort of women with histopathological diagnosis of IGM from 2014 to 2018 at Instituto Nacional Materno Perinatal in Lima, Peru. Patients' characteristics, clinical presentation, treatment, management, postoperative care, and follow-up were analyzed.
Thirty-eight patients with histopathological diagnosis of IGM were identified. Their average age was 35.9 years and 23 (60.5%) reported previous use of hormonal contraceptives. Nine (23.7%) patients had chronic mastitis with previous treatment. The time from the onset of symptoms to the first clinic consult was 5.1 months on average. Twenty-one (55.3%) patients had the lesion in the right breast, with a mean size of 6.9 cm. Conservative surgical excision was performed in all patients. Additionally, 86.8% required corticosteroids and 78.9% were treated with antibiotics. Complete remission was obtained at 141 days on average (range 44 to 292 days). Six (15.8%) women reported ipsilateral recurrence and 5 (13.2%), contralateral. The latency time was 25.5 months on average.
The conservative surgical treatment demonstrated and close follow-up made for a high cure rate, but with recurrence similar to that reported in the literature. Use of gloves is an alternative to manage post operative wounds in a low-income country. The most frequent adverse effect was breast surgical scar.
通过描述患者特征和以保守性外科切除和术后护理为治疗基石的治疗方法，报告我们在一个低收入国家管理和治疗特发性肉芽肿性乳腺炎（IGM）的经验。
回顾性分析了 2014 年至 2018 年期间在秘鲁利马的国家围产期研究所（Instituto Nacional Materno Perinatal）接受组织病理学诊断为 IGM 的女性患者。分析了患者的特征、临床表现、治疗、管理、术后护理和随访情况。
共确定了 38 例组织病理学诊断为 IGM 的患者。她们的平均年龄为 35.9 岁，23 例（60.5%）曾使用过激素避孕药。9 例（23.7%）患者有慢性乳腺炎，曾接受过治疗。从症状出现到首次就诊的时间平均为 5.1 个月。21 例（55.3%）患者的病变在右侧乳房，平均大小为 6.9cm。所有患者均行保守性外科切除。此外，86.8%的患者需要使用皮质类固醇，78.9%的患者需要使用抗生素。平均在 141 天（范围 44 至 292 天）获得完全缓解。6 例（15.8%）女性报告同侧复发，5 例（13.2%）报告对侧复发。潜伏期平均为 25.5 个月。
保守性外科治疗和密切随访显示出较高的治愈率，但复发率与文献报道相似。在低收入国家，使用手套是管理术后伤口的一种替代方法。最常见的不良反应是乳房手术疤痕。
