The Cure for Idiopathic Granulomatous Mastitis without Surgery and Steroids: One Size Does Not Fit All

Authors : Ilhan Taşdöven, Esin Kaymaz, Emrah Keskin, Hakan Balbaloglu, Güldeniz Karadeniz Çakmak

Pages : 303-312

Doi:10.29058/mjwbs.1324852

View : 69 | Download : 94

Publication Date : 2023-12-31

Article Type : Research Paper

Abstract :Aim: Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking malignancy with no consensus on the optimal treatment. We aimed to present a single-center algorithm for IGM treatment without surgery and steroids. Material and Methods: This study was conducted at Bülent Ecevit University Hospital, Zonguldak, Turkey, between 2010 and 2020. A prospective database was reviewed to identify patients with biopsyproven IGM who were managed through observation and ultrasound-guided interventions over a 10- year period. Results: Seventy-eight female patients with a confirmed diagnosis of IGM via reevaluation were determined. Of these, 34.61% required ultrasound-guided abscess aspiration and 10.25% required incisional abscess drainage without surgical resection. Complete clinical resolution was achieved within 6 months in 58.97% cases. The overall recurrence rate was 12.82%, and surgical drainage was required in one patient. Univariate logistic regression analysis revealed no statistically significant association between recurrence and the demographic or pathologic factors evaluated. Twenty-two (28.2%) patients with a histopathologic diagnosis of cystic İGM who received antibiotics (doxycycline) achieved complete resolution within 2 weeks and experienced no recurrence. Conclusion: IGM is a self-limiting disease that resolves spontaneously independent of medical intervention and without resection in up to 18 months. After diagnosis, surgery with or without steroids as the first line of therapy should be replaced with close observation and ultrasound-guided interventions according to patients’ preferences.
Keywords : granülomatöz mastit, gözlem, steroid, cerrahi, tedavi