World Journal of Surgery

, Volume 30, Issue 8, pp 1403–1409

Granulomatous Lobular Mastitis: A Complex Diagnostic and Therapeutic Problem

  • Alper Akcan
  • Hızır Akyıldız
  • Mehmet Ali Deneme
  • Hulya Akgun
  • Yucel Arıtas
Article

DOI: 10.1007/s00268-005-0476-0

Cite this article as:
Akcan, A., Akyıldız, H., Deneme, M.A. et al. World J. Surg. (2006) 30: 1403. doi:10.1007/s00268-005-0476-0

Abstract

Background

Granulomatous lobular mastitis is a rare chronic inflammatory disease of the breast. Clinical and radiological features may mimic breast carcinoma. Since this entity was first described, several clinical and pathologic features of the disease have been reported, but diagnostic features and treatment alternatives are still unclear. The purpose of this study is to evaluate diagnostic difficulties and discuss the outcome of surgical treatment in a series of 21 patients with granulomatous lobular mastitis.

Methods

A retrospective review of 21 patients with histologically confirmed granulomatous lobular mastitis treated in our center between January 1995 and May 2005 was analyzed to identify issues in the diagnosis and treatment of this rare condition.

Results

The most common presenting symptoms were a mass in the breast and pain. Four patients had no significant mammographic findings (MMG), but on ultrasound (US), 2 had irregular hypoechoic mass, and 2 hypoechoic nodular structures had abnormalities—one parenchymal distortion and 1 mass formation in 2 of these 4 patients’ magnetic resonance imaging (MRI). In recurrent cases, limited excision under local anesthesia was performed, as the clinical examination suggested carcinoma.

Conclusions

Although some findings on MMG and US are suggestive of benign breast disease, these modalities do not rule out malignancy. MRI may be helpful in patients who do not have significant pathology at MMG or US. Fine-needle aspiration cytology may be useful in some cases but diagnosis is potentially difficult because of its cytologic characteristics. Wide excision, particularly under general anesthesia, can be therapeutic as well as useful in providing an exact diagnosis.

Copyright information

© Société Internationale de Chirurgie 2006

Authors and Affiliations

  • Alper Akcan
    • 1
    • 3
  • Hızır Akyıldız
    • 2
  • Mehmet Ali Deneme
    • 1
  • Hulya Akgun
    • 2
  • Yucel Arıtas
    • 1
  1. 1.Department of General SurgeryErciyes University Medical FacultyKayseriTurkey
  2. 2.Department of PathologyErciyes University Medical FacultyKayseriTurkey
  3. 3.Department of General SurgeryErciyes University School of MedicineKayseriTurkey