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An Integrative Approach for Idiopathic Granulomatous Mastitis

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Abstract

The World Health Organization established a strategy on traditional medicine activities to facilitate integration of traditional medicine into the national health care system. Traditional and complementary medicine is now addressed by a legislation in Turkey. The aim of this study is to explore an integrative approach from for idiopathic granulomatous mastitis. This is a retrospective study. Study was carried out on idiopathic granulomatous mastitis patients who were followed in the Breast Clinic at Istanbul Medipol University Hospital for between May 2015 and September 2018. Hirudotherapy and medical cupping therapy were applied as traditional and complementary medicine integratively in accordance with the related Regulation. Radiological imaging, microbiological and histological testing, side effects, and relapses were analyzed. Radiological response was evaluated at the end of the treatment. Follow-up consisted of clinical breast exam and imaging. Thirty patients with a mean age of 34.6 years were analyzed. The average duration of symptoms was 4.6 months. Common symptoms were breast mass (100%), tenderness to palpation (73.3%), erythema (56.6%), fistula formation and deformity (43.4%), and axillary lymph nodes (43.4%). After confirmation of diagnosis of idiopathic granulomatous mastitis, patients were treated with hirudotherapy combined with medical cupping therapy. Symptoms had completely resolved within 110.3 ± 24.70 days (range 90–180) after starting treatment, and complete radiological response was confirmed 3 months after the end of the therapy by breast ultrasound or magnetic resonance imaging (MRI). All patients were successfully treated, and no evidence of relapse was experienced within the follow-up period of 22.87 ± 12.47 months. Hirudotherapy and medical cupping therapy were observed as efficient methods. Further investigations are required to validate the results in larger numbers of patients with longer follow-up. (ClinicalTrials.gov Identifier: NCT04096300).

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References

  1. Kessler E, Wolloch Y (1972) Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 58:642–646

    Article  CAS  Google Scholar 

  2. Altıntoprak F, Kivilcim T, Ozkan OV (2014) Aetiology of idiopathic granulomatous mastitis. World J Clin Cases 2:852–853

    Article  Google Scholar 

  3. Heer R, Shrimankar J, Griffith CD (2003) Granulomatous mastitis can mimic breast cancer on clinical, radiological or cythological examination: a cautionary tale. Breast 12:283–286

    Article  CAS  Google Scholar 

  4. Kim J, Tymms KE, Buckingham JM (2003) Methotrexate in the management of granulomatous mastitis. ANZ J Surg 73:247–249

    Article  Google Scholar 

  5. Raj N, Macmillan RD, Ellis LO et al (2004) Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology 43:1055–1056

    Article  CAS  Google Scholar 

  6. Bani-Hani KE, Yaghan RJ, Matalka II, Shatnawi NJ (2004) Idiopathic granulomatous mastitis: time to avoid unnecessary mastectomies. Breast J 10:318–322

    Article  Google Scholar 

  7. Al-Khaffaf B, Knox F, Bundred NJ (2008) Idiopathic granulomatous mastitis: a 25-year experience. J Am Coll Surg 206:269–273

    Article  Google Scholar 

  8. Sixty-Second World Health Assembly. World Health Organization.Wha62/2009/Rec/1:19–21

  9. Geleneksel ve tamamlayıcı tıp uygulamaları yonetmeligi. Resmi Gazete, Sayı: 29158. Retrieved from http://www.resmigazete. gov.tr/eskiler/2014/10/20141027–3.htm

  10. Sig AK, Guney M, Guclu AU, Ozmen E (2017) Medicinal leech therapy—an overall perspective. Integr Med Res 6(4):337–343

    Article  Google Scholar 

  11. Michalsen A, Roth M, Dobos G (2007) Medicinal leech therapy. Georg Thieme, New York

    Book  Google Scholar 

  12. Whitaker IS, Oboumarzouk O, Rozen WM, Naderi N, Balasubramanian SP, Azzopardi EA, Kon M (2012) The efficacy of medicinal leeches in plastic and reconstructive surgery: a systematic review of 277 reported clinical cases. Microsurgery 32(3):240–250

    Article  Google Scholar 

  13. Abdualkader AM, Ghawi AM, Alaama M, Awang M, Merzouk A (2013) Leech therapeutic applications. Indian J Pharm Sci 75(2):127–137

    CAS  PubMed  PubMed Central  Google Scholar 

  14. The art of cupping, Hedwig Manz (2007) p 49, © 2009 Georg Thieme Verlag, Printed in Germany by OAN Offizin Andersen

  15. Freeman CM, Xia BT, Lewis JD et al (2017) Idiopathic granulomatous mastitis: a diagnostic and therapeutic challenge. Am J Surg 214:701–706

    Article  CAS  Google Scholar 

  16. Yılmaz TU, Gürel B, Güler SA, Baran MA, Ersan B, Duman S, Utkan Z (2018) Scoring idiopathic granulomatous mastits: an effective system for predicting recurrence? Eur J Breast Health 14:112–116

    PubMed  PubMed Central  Google Scholar 

  17. Fazzio RT, Shah SS, Sandhu NP, Glazebrook KN (2016) Idiopathic granulomatous mastitis: imaging update and review. Insights Imaging 7:531–539

    Article  Google Scholar 

  18. Sheybani F, Sarvghad MR, Naderi HR, Gharib M (2015) Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol 125(4):801–807

    Article  CAS  Google Scholar 

  19. Chirappapha P, Thaweepworadej P, Supsamutchai C, Biadul N, Lertsithichai P (2018) Idiopathic granulomatous mastitis: a retrospective cohort study between 44 patients with different treatment modalities. Annals Med Surg 36:162–167

    Article  Google Scholar 

  20. Aghajanzadeh M, Hassanzadeh R, Alizadeh SS et al (2015) Granulomatous mastitis: presentations, diagnosis, treatment and outcome in 206 patients from the north of Iran. Breast 24:456–460

    Article  Google Scholar 

  21. Illman JE, Terra SB, Clapp AJ et al (2018) Granulomatous diseases of the breast and axilla. Radiological findings with pathological correlation. Insights Imaging 9:59–71

    Article  Google Scholar 

  22. Ocal K, Dag A, Turkmenoglu O, Kara T, Seyit H, Konca K (2010) Granulomatous mastitis: clinical , pathological features, and management. Breast J 16(2):176–182

    Article  Google Scholar 

  23. Kim J, Tymms KF, Buckingham JM (2003) Methotraxate in the management of granulomatous mastitis. ANZ J Surg 73(4):247–249

    Article  Google Scholar 

  24. Bani-Hani KE, Yaghan RJ, Matalka II, Sharnawi NJ (2004) Idiopathic granulomatous mastitis: time to avoid unnecessary mastectomies. Breast J 10(4):318–322

    Article  Google Scholar 

  25. Yau FM, Macadam SA, Kuusk U, Nimmo M, Van Laeken N (2010) The surgical management of granulomatous mastitis. Ann Plast Surg 64(1):9–16

    Article  CAS  Google Scholar 

  26. Lai EC, Chan WC, Ma TK, Tang AP, Poon CS, Leong HT (2005) The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 11(6):454–456

    Article  Google Scholar 

  27. Philip J, Armitage DW, Phillips KR, Parr NJ (2003) Leech therapy for penoscrotal oedema in patients with hormone-refractory prostate carcinoma. BJU Int 91:579–580

    Article  CAS  Google Scholar 

  28. Al-Bedah AMN, Elsubai IS, Qureshi NA, Aboushanab TS, Ali GIM, El-Olemy AT, Khalil AAH, Khalil MKM, Alqaed MS (2019) The medical perspective of cupping therapy: effects and mechanisms of action. J Tradit Complement Med 9:90–97

    Article  Google Scholar 

  29. Mehta P, Dhapte (2015) Cupping therapy: a prudent remedy for a plethora of medical ailments. J Tradit Complement Med 5(3):127–134

    Article  Google Scholar 

  30. Aboushanab TS, Saud AlSanad S (2018) Cupping therapy: an overview from a modern medicine perspective. J Acupunct Meridian Stud 11(3):83–87

    Article  Google Scholar 

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Acknowledgments

The authors would like to express their thanks to Dr. Deniz Esin who is an internal medicine specialist and traditional medicine practitioner and Ms. Sevinc Celenk who is a traditional medicine practitioner for sharing their experience.

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Authors and Affiliations

  1. Turkish Holistic & Integrative Medicine Association, Istanbul, Turkey

    Mujgan Caliskan & Ali Timucin Atayoglu

  2. Department of General Surgery, Medipol University, Istanbul, Turkey

    Mujgan Caliskan & Ayse Altay

  3. Department of Radiology, Medipol University, Istanbul, Turkey

    Abdulkadir Eren

  4. Department of Family Medicine, Istanbul Medipol University, Esenler Hospital, Istanbul, Turkey

    Ali Timucin Atayoglu

Authors
  1. Mujgan Caliskan
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  2. Ayse Altay
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  3. Abdulkadir Eren
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  4. Ali Timucin Atayoglu
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Correspondence to Ali Timucin Atayoglu.

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Ethical Approval

Local ethics committee of Istanbul Medipol University Ethics Committee (No: 396). This research involves human participants.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Consent form was filled out by all participants for using data in their clinical records for this study.

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Ali Timucin Atayoglu is currently the president of Turkish Holistic & Integrative Medicine Association.

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Image 1 A typical hirudotherapy process (PNG 836 kb)

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Caliskan, M., Altay, A., Eren, A. et al. An Integrative Approach for Idiopathic Granulomatous Mastitis. Indian J Surg 83 (Suppl 2), 388–394 (2021). https://doi.org/10.1007/s12262-020-02170-6

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  • DOI: https://doi.org/10.1007/s12262-020-02170-6

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