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Rifampicin for Idiopathic Granulomatous Lobular Mastitis: A Promising Alternative for Treatment

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Abstract

Background

Idiopathic granulomatous lobular mastitis (IGLM) is a chronic, non-caseating, inflammatory breast disease of obscure aetiology characterized by multiple masses, abscesses and sinus formation. There is no standard treatment to date, but surgical procedures and systemic corticosteroids are effective in its treatment despite high recurrence rates.

Patients and methods

This prospective study including 30 patients with IGLM between November 2012 and May 2016 aimed to investigate the possibility of administration of Rifampicin (300 mg twice daily for a period of 6–9 months) as an alternative therapy for both surgery and corticosteroids in patients with IGLM. All patients were diagnosed by core needle biopsy.

Results

All patients were of reproductive age and had a history of breast feeding, which is the most important predisposing factor for IGLM. The mean age was 31.6 ± 5.8 years (range 23–42 years). Eighteen patients (60%) were treated by Rifampicin for 6 months, whereas 12 patients (40%) were treated for 9 months. Twelve months after the beginning of therapy, all patients showed complete clinical and ultrasonographic responses. No serious side effects were reported to stop the treatment course. The median follow-up after finishing the course of treatment was 15.5 months (average 3–35 months) with no episodes of disease relapse.

Conclusion

Rifampicin is effective in the treatment of patients with IGLM with complete clinical and ultrasonographic response after 6–9 months and could be used as a solo medical therapy alternative to both surgery and corticosteroids.

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Authors and Affiliations

  1. Surgical Oncology Department, Faculty of Medicine, Oncology Center-Mansoura University (OCMU), Mansoura, Egypt

    Omar Farouk, Mohamed Abdelkhalek, Ahmed Abdallah, Ahmed Senbel, Essam Attia, Mohamed Abd Elghaffar & Mahmoud Mesbah

  2. Clinical Pharmacology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Ahmed Shata

  3. Diagnostic Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Nermine Soliman

  4. Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Maha Amin & Dina El-Tantawy

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  1. Omar Farouk
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  2. Mohamed Abdelkhalek
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Correspondence to Omar Farouk.

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Farouk, O., Abdelkhalek, M., Abdallah, A. et al. Rifampicin for Idiopathic Granulomatous Lobular Mastitis: A Promising Alternative for Treatment. World J Surg 41, 1313–1321 (2017). https://doi.org/10.1007/s00268-016-3857-7

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