Diagnosis, Differential ; Female ; Granulomatous Mastitis/drug therapy* ; Humans ; Mammography

Idiopathic granulomatous mastitis (IGM) is a rare and chronic benign disease of the breast. Histologically, the disease presents as an intense inflammatory reaction with non-caseated granulomas that are the characteristic symptom of the disease. No consensus exists on the best treatment modality for this disease. In this report, we present a patient with granulomatous mastitis who was treated successfully with low-dose oral and topical steroids. Our aim here is to discuss various approaches for IGM in view of the literature and present treatment with topical steroids, which has not been reported.
Administration, Cutaneous ; Administration, Oral ; Adult ; Biopsy ; Female ; Granulomatous Mastitis/diagnosis/*drug therapy ; Humans ; Magnetic Resonance Imaging ; Steroids/*administration & dosage ; Treatment Outcome

OBJECTIVETo study the clinicopathologic features of granulomatous lobular mastitis and mammary duct ectasia.

METHODSThe clinicopathologic data from August 2005 to May 2013 of 32 cases of granulomatous lobular mastitis and mammary duct ectasia were retrospectively reviewed.

RESULTSThe age of patients ranged from 26 to 45 years. Two patients had no history of delivery. Fourteen patients had no history of lactation or lactational disorder in the lesional side. Most of the remaining patients had history of breast feeding. Gross examination showed that the lesions were poorly circumscribed and varied from 3 to 12 cm in greatest dimension. Tiny abscess cavities, ranging from 0.1 to 0.5 cm in diameter and containing light yellowish to greyish secretion, were demonstrated. Histologic examination showed granuloma formation and ductal dilatation. Eleven patients had received antibiotic treatment. Twelve cases were complicated by sinus formation related to skin incision and drainage. The duration of follow-up ranged from 5 to 90 months. Three cases showed ipsilateral recurrence and 3 cases had similar pathology in the contralateral breast. Four patients defaulted follow-up.

CONCLUSIONSGranulomatous lobular mastitis is associated with mammary duct ectasia. Accurate pathologic diagnosis is prudent for clinical management and control of local recurrence.

Adult ; Anti-Bacterial Agents ; therapeutic use ; Breast Diseases ; complications ; drug therapy ; pathology ; surgery ; Breast Feeding ; Dilatation, Pathologic ; complications ; drug therapy ; pathology ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Granulomatous Mastitis ; complications ; drug therapy ; pathology ; surgery ; Humans ; Mammary Glands, Human ; pathology ; surgery ; Middle Aged ; Recurrence ; Retrospective Studies