Title: Idiopathic Granulomatous Mastitis: Time to Avoid Unnecessary Mastectomies
Abstract: The Breast JournalVolume 10, Issue 4 p. 318-322 Idiopathic Granulomatous Mastitis: Time to Avoid Unnecessary Mastectomies Kamal E. Bani-Hani MD, FRCS, Corresponding Author Kamal E. Bani-Hani MD, FRCS Departments of SurgeryAddress correspondence and reprint requests to: Kamal E. Bani-Hani, MD, FRCS, Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan, or e-mail: [email protected].Search for more papers by this authorRami J. Yaghan FRCS, Rami J. Yaghan FRCS Departments of SurgerySearch for more papers by this authorIsmail I. Matalka MRCPath, Ismail I. Matalka MRCPath Pathology, Jordan University of Science and Technology, Irbid, JordanSearch for more papers by this authorNawaf J. Shatnawi FRCS, Nawaf J. Shatnawi FRCS Departments of SurgerySearch for more papers by this author Kamal E. Bani-Hani MD, FRCS, Corresponding Author Kamal E. Bani-Hani MD, FRCS Departments of SurgeryAddress correspondence and reprint requests to: Kamal E. Bani-Hani, MD, FRCS, Department of Surgery, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan, or e-mail: [email protected].Search for more papers by this authorRami J. Yaghan FRCS, Rami J. Yaghan FRCS Departments of SurgerySearch for more papers by this authorIsmail I. Matalka MRCPath, Ismail I. Matalka MRCPath Pathology, Jordan University of Science and Technology, Irbid, JordanSearch for more papers by this authorNawaf J. Shatnawi FRCS, Nawaf J. Shatnawi FRCS Departments of SurgerySearch for more papers by this author First published: 05 July 2004 https://doi.org/10.1111/j.1075-122X.2004.21336.xCitations: 160Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat Abstract Abstract: Idiopathic granulomatous mastitis is a rare disease of the breast. Clinically and radiologically it may mimic breast carcinoma. Awareness of surgeons, pathologists, and radiologists is essential to avoid unnecessary mastectomies. Data regarding 24 patients with histologically confirmed idiopathic granulomatous mastitis treated at our center over 8 years were analyzed. The mean age of patients was 34.3 years. Breast lump was the most common presentation. The right breast was affected in 16 cases. Four patients were pregnant at the time of presentation. Lactation within 6 months of presentation was documented in four patients. Two patients used contraceptives pills. A clinical suspicion of malignancy was present in 17 cases. Mammography was performed in 16 patients and showed focal asymmetrical dense lesions in 9, well-circumscribed opacity in 4, spiculated lesion in 1, and was normal in 2. Fine-needle aspiration was performed in 17 patients, of which 2 were reported as malignant. Wide local excision was the mainstay of treatment. One patient underwent mastectomy upon clinical, mammographic, and repeated cytologic findings consistent with malignancy, and the final histology confirmed idiopathic granulomatous mastitis with no evidence of malignancy. Four patients developed recurrence after a mean follow-up of 31.2 months. A greater awareness of the rare entity of idiopathic granulomatous mastitis is mandatory to avoid unnecessary mastectomies. Clinical, radiologic, and even cytologic findings are sometimes confused with malignancy. To the best of our knowledge, our patient who developed the disease at the age of 11 years is the youngest reported case. REFERENCES 1 Tavassoli FA. Pathology of the Breast, 2nd ed. NewYork: McGraw-Hill, 1999. Google Scholar 2 Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 1972; 58: 642–46. 10.1093/ajcp/58.6.642 CASPubMedWeb of Science®Google Scholar 3 Cohen C. Granulomatous mastitis. A review of 5 cases. S Afr Med J 1977; 52: 14–16. PubMedWeb of Science®Google Scholar 4 Sakurai T, Oura S, Tanino H, et al. A case of granulomatous mastitis mimicking breast carcinoma. Breast Cancer 2002; 9: 265–68. 10.1007/BF02967601 PubMedGoogle Scholar 5 Cakir B, Tuncbilek N, Karakas HM, Unlu E, Ozyilmaz F. Granulomatous mastitis mimicking breast carcinoma. Breast J 2002; 8: 251–52. 10.1046/j.1524-4741.2002.08413.x CASPubMedGoogle Scholar 6 Poniecka AW, Krasuski P, Gal E, Lubin J, Howard L, Poppiti RJ. Granulomatous inflammation of the breast in a pregnant woman: report of a case with fine needle aspiration diagnosis. Acta Cytol 2001; 45: 797–801. 10.1159/000328309 CASPubMedWeb of Science®Google Scholar 7 Cserni G, Szajki K. Granulomatous lobular mastitis following drug-induced galactorrhea and blunt trauma. Breast J 1999; 5: 398–403. 10.1046/j.1524-4741.1999.97040.x PubMedGoogle Scholar 8 Schelfout K, Tjalma WA, Cooremans ID, Coeman DC, Colpaert CG, Buytaert PM. Observations of an idiopathic granulomatous mastitis. Eur J Obstet Gynecol Reprod Biol 2001; 97: 260–62. 10.1016/S0301-2115(00)00546-7 CASPubMedWeb of Science®Google Scholar 9 Erhan Y, Veral A, Kara E, et al. A clinicopathologic study of a rare clinical entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast 2000; 9: 52–56. 10.1054/brst.1999.0072 CASPubMedWeb of Science®Google Scholar 10 Imoto S, Kitaya T, Kodama T, Hasebe T, Mukai K. Idiopathic granulomatous mastitis: case report and review of the literature. Jpn J Clin Oncol 1997; 27: 274–77. 10.1093/jjco/27.4.274 CASPubMedWeb of Science®Google Scholar 11 Kfoury H, Al Bhlal L. Granulomatous lobular mastitis: a clinicopathological study of 12 cases. Ann Saudi Med 1997; 17: 43–46. 10.5144/0256-4947.1997.43 CASPubMedWeb of Science®Google Scholar 12 Ayeva-Derman M, Perrotin F, Lefrancq T, Roy F, Lansac J, Body G. Idiopathic granulomatous mastitis. Review of the literature illustrated by 4 cases. J Gynecol Obstet Biol Reprod 1999; 28: 800–807. CASPubMedGoogle Scholar 13 Salam IM, Alhomsi MF, Daniel MF, Sim AJ. Diagnosis and treatment of granulomatous mastitis. Br J Surg 1995; 82: 214. 10.1002/bjs.1800820227 CASPubMedWeb of Science®Google Scholar 14 Brown KL, Tang PH. Postlactational tumoral granulomatous mastitis: a localized immune phenomenon. Am J Surg 1979; 138: 326–29. 10.1016/0002-9610(79)90397-0 CASPubMedWeb of Science®Google Scholar 15 Carmalt HL, Ramsey-Stewart G. Granulomatous mastitis. Med J Aust 1981; 1: 356–59. 10.5694/j.1326-5377.1981.tb135631.x CASPubMedWeb of Science®Google Scholar 16 Miliauskas JR, Pieterse AS, Williams RS. Granulomatous lobular mastitis. Aust N Z J Surg 1995; 65: 139–41. 10.1111/j.1445-2197.1995.tb07281.x PubMedWeb of Science®Google Scholar 17 Going JJ, Anderson TJ, Wilkinson S, Chetty U. Granulomatous lobular mastitis. J Clin Pathol 1987; 40: 535–40. 10.1136/jcp.40.5.535 CASPubMedWeb of Science®Google Scholar 18 Pouchot J, Foucher E, Lino M, Barge J, Vinceneux P. Granulomatous mastitis: an uncommon cause of breast abscess. Arch Intern Med 2001; 161: 611–12. 10.1001/archinte.161.4.611 CASPubMedWeb of Science®Google Scholar 19 Diallo R, Frevel T, Poremba C, Cirkel U, Metze D, Dockhorn-Dworniczak B. Lupus vulgaris as the etiology of tuberculous mastitis. Pathologe 1997; 18: 67–70. 10.1007/s002920050198 CASPubMedWeb of Science®Google Scholar 20 Yilmaz E, Lebe B, Usal C, Balci P. Mammographic and sonographic findings in the diagnosis of idiopathic granulomatous mastitis. Eur Radiol 2001; 11: 2236–40. 10.1007/s003300100965 CASPubMedWeb of Science®Google Scholar 21 Memis A, Bilgen I, Ustun EE, Ozdemir N, Erhan Y, Kapkac M. Granulomatous mastitis: imaging findings with histopathologic correlation. Clin Radiol 2002; 57: 1001–6. 10.1053/crad.2002.1056 CASPubMedWeb of Science®Google Scholar 22 Han BK, Choe YH, Park JM, et al. Granulomatous mastitis: mammographic and sonographic appearances. AJR Am J Roentgenol 1999; 173: 317–20. 10.2214/ajr.173.2.10430126 CASPubMedWeb of Science®Google Scholar 23 Gal-Gombos EC, Esserman LE, Odzer SL, Weisberg S, Wilson C, Poppiti RJ Jr. Granulomatous mastitis: diagnosis by ultrasound-guided core biopsy. Breast J 2001; 7: 129–30. 10.1046/j.1524-4741.2001.007002129.x CASPubMedGoogle Scholar 24 Newnham MS, Shirley SE, McDonald AH. Granulomatous lobular mastitis. A case report and review of the literature. West Indian Med J 2001; 50: 236–38. CASPubMedWeb of Science®Google Scholar 25 Jorgensen MB, Nielsen DM. Diagnosis and treatment of granulomatous mastitis. Am J Med 1992; 93: 97–101. 10.1016/0002-9343(92)90688-8 CASPubMedWeb of Science®Google Scholar 26 Goldberg J, Baute L, Storey L, Park P. Granulomatous mastitis in pregnancy. Obstet Gynecol 2000; 96: 813–15. 10.1016/S0029-7844(00)01051-6 CASPubMedWeb of Science®Google Scholar 27 Yip CH, Jayaram G, Swain M. The value of cytology in granulomatous mastitis: a report of 16 cases from Malaysia. Aust N Z J Surg 2000; 70: 103–5. 10.1046/j.1440-1622.2000.01764.x CASPubMedWeb of Science®Google Scholar 28 DeHertogh DA, Rossof AH, Harris AA, Economou SG. Prednisone management of granulomatous mastitis. N Engl J Med 1980; 303: 799–800. 10.1056/NEJM198010023031406 CASPubMedWeb of Science®Google Scholar Citing Literature Volume10, Issue4July 2004Pages 318-322 ReferencesRelatedInformation