Advertisement

World Journal of Surgery

, Volume 39, Issue 11, pp 2718–2723 | Cite as

Topical Steroids Are Effective in the Treatment of Idiopathic Granulomatous Mastitis

  • Fatih AltintoprakEmail author
  • Taner Kivilcim
  • Omer Yalkin
  • Yener Uzunoglu
  • Zeynep Kahyaoglu
  • Osman Nuri Dilek
Original Scientific Report

Abstract

Background

Idiopathic granulomatous mastitis (IGM) is a rare, benign, and chronic disease of the breast. Despite the various treatment approaches described for this disease, a gold standard treatment modality has not yet been defined. In this study, the effect of topical steroids was reviewed and assessed in patients with IGM.

Methods

The records of patients with IGM who were treated only with topical steroids were retrospectively reviewed. Patients were grouped as “completely healed,” “inadequately healed,” “stable,” “worsened,” or “recurred” if they had once healed but their symptoms returned. Patients whose skin changes were completely ameliorated were considered “completely healed.”

Results

All of the patients were women, and the average patient age was 35.7 years (range 24–48 years). During the average follow-up of 37.2 months (range 12–72 months) in patients who received only topical steroid treatment, recurrence was observed in three patients (3/28, 10.7 %), and no side effects or steroid-related complications occurred.

Conclusions

Topical steroids seem to be effective in the treatment of IGM characterized by skin changes. Prospective clinical studies would be useful in determining the clinical efficacy of topical steroids in the treatment of IGM.

Keywords

Atopic Dermatitis Steroid Treatment Topical Steroid Breast Skin Idiopathic Granulomatous Mastitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Diesing D, Axt-Fliedner R, Hornung D et al (2004) Granulomatous mastitis. Arch Gynecol Obstet 269(4):233–236CrossRefPubMedGoogle Scholar
  2. 2.
    Bani-Hani KE, Yaghan RJ, Matalka II et al (2004) Idıopathic granulomatous mastitis: time to avoid unnecesary mastectomies. Breast J 10(4):318–322CrossRefPubMedGoogle Scholar
  3. 3.
    Kessler E, Wolloch Y (1972) Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 58(6):642–646PubMedGoogle Scholar
  4. 4.
    Heer R, Shrimankar J, Griffith CD (2003) Granulomatous mastitis can mimic breast cancer on clinical, radiological, or cytological examination: a cautionary tale. Breast 12(4):283–286CrossRefPubMedGoogle Scholar
  5. 5.
    Guven HE, Pak I, Oral S (2006) Granulomatous mastitis: surgical outcomes. J Coll Physicians Surg Pak 16(6):431–433PubMedGoogle Scholar
  6. 6.
    Asoglu O, Ozmen V, Karanlik H et al (2005) Feasibility of surgical management in patients with granulomatous mastitis. Breast J 11(2):108–114CrossRefPubMedGoogle Scholar
  7. 7.
    Kok KY, Telisinqhe PU (2010) Granulomatous mastitis: presentation, treatment and outcome in 43 patients. Surgeon 8(4):197–201CrossRefPubMedGoogle Scholar
  8. 8.
    Ocal K, Dag A, Turkmenoglu O et al (2010) Granulomatous mastitis: clinical, pathologic features, and management. Breast J 16(2):176–182CrossRefPubMedGoogle Scholar
  9. 9.
    Azlina AF, Ariza Z, Arni T et al (2003) Chronic granulomatous mastitis: diagnostic and therapeutic considerations. World J Surg 27(5):515–518CrossRefPubMedGoogle Scholar
  10. 10.
    Yau FM, Macadam SA, Kuusk U et al (2010) The surgical management of granulomatous mastitis. Ann Plast Surg 64(1):9–16CrossRefPubMedGoogle Scholar
  11. 11.
    DeHertogh DA, Rossof AH, Harris AA et al (1980) Prednisone management of granulomatous mastitis. N Eng J Med 303(14):799–800CrossRefGoogle Scholar
  12. 12.
    Fetveit T, Uqqerud R (1993) Granulomatous mastitis in a patient treated with prednisone. Tidsskr Nor Laegeforen 113(23):2906–2907PubMedGoogle Scholar
  13. 13.
    Aldaqal SM (2004) Idiopathic granulomatous mastitis. Clinical presentation, radiological features and treatment. Saudi Med J 25(12):1884–1887PubMedGoogle Scholar
  14. 14.
    Katz U, Molad Y, Ablin J et al (2007) Chronic idiopathic granulomatous mastitis. Ann Y Acad Sci 1108:603–608CrossRefGoogle Scholar
  15. 15.
    Erozgen F, Ersoy YE, Akaydin M et al (2010) Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Res Treat 123(2):447–452CrossRefPubMedGoogle Scholar
  16. 16.
    Kim J, Tymms KE, Buckingham JM (2003) Methotrexate in the management of granulomatous mastitis. ANZ J Surg 73(4):247–249CrossRefPubMedGoogle Scholar
  17. 17.
    Maffini F, Baldini F, Bassi F et al (2009) Systemic therapy as a first choice treatment for idiopathic granulomatous mastitis. J Cutan Pathol 36(6):689–691CrossRefPubMedGoogle Scholar
  18. 18.
    Su FH, Liu SC, Suen JH et al (2005) Idiopathic granulomatous mastitis: a case successfully treated with a minimum dose of a steroid. Chang Gung Med J 28(6):431–435PubMedGoogle Scholar
  19. 19.
    Tuli R, O’Hara BJ, Hines J et al (2007) Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: a case report and review of the literature. Int Semin Surg Oncol 4:21PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Chrousos GP (2001) Glucocorticoid therapy. In: Felig P, Frohman L (eds) Endocrinology and metabolism, 4th edn. McGraw-Hill, Incorporated, New York, pp 609–612Google Scholar
  21. 21.
    Peppa M, Krania M, Reptis SA (2011) Hypertension and other morbidities with Cushing’s syndrome associated with corticosteroids: a review. Integr Blood Press Control 4:7–16PubMedCentralCrossRefPubMedGoogle Scholar
  22. 22.
    Akbulut S, Yilmaz D, Bakir S (2011) Methotrexate in the management of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases. Breast J 17(6):661–668CrossRefPubMedGoogle Scholar
  23. 23.
    Raj N, Macmillan RD, Ellis IO et al (2004) Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology 43(8):1055–1056CrossRefPubMedGoogle Scholar
  24. 24.
    Joly P, Roujeau JC, Benichou J, Bullous Diseases French Study Group et al (2002) A comparison of oral and topical corticosteroids in patients with bullous pemphidoid. N Eng J Med 346(5):321–327CrossRefGoogle Scholar
  25. 25.
    Buys LM (2007) Treatment options for atopic dermatitis. Am Fam Physician 75(4):523–528PubMedGoogle Scholar
  26. 26.
    Bewley A, Dermatology Working Group (2008) Expert consensus: time for a change in the way we advise our patients to use topical. Br J Dermatol 158(5):917–920CrossRefPubMedGoogle Scholar
  27. 27.
    Kiyak G, Dumlu EG, Kilinc I et al (2014) Management of idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment. BMC Surg 14:66. doi: 10.1186/1471-2482-14-66 PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Atak T, Sagiroglu J, Eren T et al (2015) Strategies to treat idiopathic granulomatous mastitis; retrospective analysis of 40 patients. Breast Dis 35(1):19–24PubMedGoogle Scholar
  29. 29.
    Salesi M, Karimifar M, Salimi F et al (2011) A case of granulomatous mastitis with erythema nodosum and arthritis. Rheumatol Int 31(8):1093–1095CrossRefPubMedGoogle Scholar
  30. 30.
    Hanifin J, Gupta AK, Rajagopalan R (2002) Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients. Br J Dermatol 147(3):528–537CrossRefPubMedGoogle Scholar
  31. 31.
    Lai EC, ChanWC Ma TK et al (2005) The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 11(6):454–456CrossRefPubMedGoogle Scholar
  32. 32.
    Altintoprak F (2011) Topical steroids to treat granulomatous mastitis: a case report. Korean J Intern Med 26(3):356–359PubMedCentralCrossRefPubMedGoogle Scholar
  33. 33.
    Casteren CV, Jacquemyn Y, Himpe E et al (2012) Idiopathic ganulomatous mastitis. BMJ Case Rep. doi: 10.1136/bcr-2012 Google Scholar
  34. 34.
    Gunduz Y, Altintoprak F, Tatli Ayhan L et al (2014) Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation. Breast J 20(6):586–591CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Fatih Altintoprak
    • 1
    Email author
  • Taner Kivilcim
    • 2
  • Omer Yalkin
    • 2
  • Yener Uzunoglu
    • 2
  • Zeynep Kahyaoglu
    • 3
  • Osman Nuri Dilek
    • 1
    • 4
  1. 1.Department of General Surgery, Faculty of MedicineSakarya UniversitySakaryaTurkey
  2. 2.Department of General Surgery, Research and Educational HospitalSakarya UniversitySakaryaTurkey
  3. 3.Department of Pathology, Research and Educational HospitalSakarya UniversitySakaryaTurkey
  4. 4.Department of General Surgery, Faculty of MedicineKatip Celebi UniversitySakaryaTurkey

Personalised recommendations