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Corticosteroid treatment in the management of idiopathic granulomatous mastitis to avoid unnecessary surgery

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Abstract

Purpose

Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. It can mimic breast carcinoma clinically and radiologically, and usually affects females of childbearing age. There is no commonly accepted optimal treatment for IGM. In this study, we present the clinical and histopathological features and outcomes of the therapeutic management of IGM, as well as the clinical course of the disease when patients were treated with oral corticosteroids.

Methods

This retrospective study included 49 of 87 patients who met the required histological criteria for IGM who were followed up between January 2009 and December 2011. All patients had a disease-free follow-up period of at least 6 months. The data regarding the clinical features at presentation, laboratory values and the treatment modalities were obtained from the medical records of the patients.

Results

The mean age of the patients was 34.3 ± 4.37 years. Forty patients were treated with prednisolone, five were started on antituberculosis treatment, two received non-steroidal anti-inflammatory drugs, one received antibiotics and one underwent wide excision. All patients who received steroids responded well to the therapy.

Conclusion

Systemic therapy with corticosteroids is an effective and appropriate treatment option for IGM. It can provide complete disease resolution and prevent recurrence in the long term. A multidisciplinary approach including specialists in the fields of both general surgery and infectious diseases is essential for the diagnosis, treatment and follow-up of IGM.

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Authors and Affiliations

  1. Department of General Surgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Tulay Mizrakli, Mehmet Velidedeoglu, Fatih Aydogan & Asiye Perek

  2. Department of Infectious Diseases, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Mucahit Yemisen, Birgul Mete & Resat Ozaras

  3. Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Fahrettin Kilic & Halit Yilmaz

  4. Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Tulin Ozturk

  5. Cerrahpasa Tip Fakultesi, Genel Cerrahi, Fatih, 34098, Istanbul, Turkey

    Fatih Aydogan

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  1. Tulay Mizrakli
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  2. Mehmet Velidedeoglu
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  3. Mucahit Yemisen
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Correspondence to Fatih Aydogan.

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Mizrakli, T., Velidedeoglu, M., Yemisen, M. et al. Corticosteroid treatment in the management of idiopathic granulomatous mastitis to avoid unnecessary surgery. Surg Today 45, 457–465 (2015). https://doi.org/10.1007/s00595-014-0966-5

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