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Idiopathic granulomatous mastitis: clinical, histopathological, and radiological characteristics and management approaches

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Abstract

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.

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Authors and Affiliations

  1. School of Medicine, The University of Jordan, Amman, Jordan

    Muayad I. Azzam & Majed W. Al-Nazer

  2. Division of Rheumatology, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, 11942, Jordan

    Fatima Alnaimat

  3. Department of Pathology, School of Medicine, University of Jordan, Amman, 11942, Jordan

    Heyam Awad

  4. Department of General Surgery, School of Medicine, University of Jordan, Amman, 11942, Jordan

    Ghada Odeh, Rami Addasi & Jamal Masad Melhem

  5. Department of Radiology and Nuclear Medicine, School of Medicine, University of Jordan, Amman, 11942, Jordan

    Mahasen Al-Najar

  6. Department of Rheumatology, Abdali Hospital, Amman, Jordan

    Suzan Alsayed

  7. Women’s Health and Breast Center, Abdali Hospital, Amman, Jordan

    Layal El-Asir

  8. Division of Rheumatology, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA

    Nadera J. Sweiss

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  1. Muayad I. Azzam
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Correspondence to Fatima Alnaimat.

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The study was conducted following the Declaration of Helsinki and approved by the Institutional Review Board (IRB) of Jordan University Hospital (IRB number 67/2020/1784).

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Azzam, M.I., Alnaimat, F., Al-Nazer, M.W. et al. Idiopathic granulomatous mastitis: clinical, histopathological, and radiological characteristics and management approaches. Rheumatol Int 43, 1859–1869 (2023). https://doi.org/10.1007/s00296-023-05375-6

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