Idiopathic granulomatous mastitis: an institutional experience
Seetharam Prasad1, Padmapriya Jaiprakash2, Aniket Dave1, Deepti Pai1
1Department of General Surgery, Kasturba Medical College, Manipal, India
2Department of Pathology, Kasturba Medical College, Manipal, India
Keywords: Idiopathic, granulomatous, mastitis
Objective: To study idiopathic granulomatous mastitis with respect to its various clinical features, etiologic factors, treatment modalities and complications.
Material and methods: Retrospective study of all patients who were diagnosed with idiopathic granulomatous mastitis from 1st January 2006 to 31st December 2014 at Kasturba Hospital, Manipal, India (a tertiary care referral centre). The research was performed according to the World Medical Association Declaration of Helsinki. Informed consent was taken from the patient before invasive procedures including surgery. Data was analysed using the Statistical Package for Social Sciences version 16.0 wherever appropriate.
Results: 73 patients diagnosed with idiopathic granulomatous mastitis during the time period were included. One patient was a male (1.37%), rest were all females (98.63%). The mean age of presentation was 32.67 years (range 23 to 66 years). 70 patients (95.89%) were parous females. Average duration since last childbirth was 4.6 years (range: 3 months to 33 years). 8 patients (10.95%) were lactating. History of oral contraceptive pill use was present in 40 patients (54.79%). The right breast was affected in 44 patients (60.27%), and the left breast in 29 patients (39.73%). None of the patients had bilateral disease. The most common symptom was a painless lump (61.64%). Rest of the patients (38.36%) presented with features of a breast abscess. 19 out of 39 FNACs done (48.72%) were positive for granulomatous mastitis. 59 were primarily managed surgically (lumpectomy/ wide excision-33, incision & drainage-26). One patient was treated primarily with prednisolone. 13 patients did not receive specific treatment, and were only kept on regular follow-up. Patients managed with lumpectomy/ wide excision had the least rate of complications & recurrence (18.18%).
Conclusion: Patients with idiopathic granulomatous mastitis can present with a wide variety of symptoms which mimic other more common conditions. Surgical management in the form of wide excision appears to provide the best long term outcome in patients with idiopathic granulomatous mastitis.
Cite this paper as: Prasad S, Jaiprakash P, Dave A, Pai D. Idiopathic granulomatous mastitis: an institutional experience. Turk J Surg 2017; 33(2): 100-103
Authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects”. (amended in October 2013).
Written informed consent was obtained from patient who participated in this study.
Concept - S.S.P., P.P.J.; Design - S.S.P.; Supervision - S.S.P., P.P.J.; Resource - S.S.P., P.P.J.; Materials - A.D., D.P.; Data Collection and/or Processing - A.D., D.P.; Analysis and/or Interpretation - P.P.J., A.D.; Literature Search - P.P.J., A.D.; Writing Manuscript - A.D., D.P.; Critical Reviews - S.S.P., P.P.J.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.