Volume 25, Issue 110, April 2021

Outcome of wide local excision with and without corticosteroid therapy in management of idiopathic granulomatous mastitis

Amira Maher R¹, Osama Al Atarash¹, El-Shinawi M^1,2, Fahmy K¹, Ahmed Gamal Eldin Osman¹

¹Department of General Surgery, Breast surgery unit, Ain Shams University, Egypt
²Vice President, Galala University, Egypt

ABSTRACT

Introduction: Idiopathic granulomatous mastitis is considered as one of the rare benign breast disease. It can be misdiagnosed as breast carcinoma both clinically and radiologically. Tissue biopsy and histopathological assessment is the gold standard for diagnosis. Proper management of Idiopathic granulomatous mastitis is still controversial. In our study, we aimed to evaluate the addition of corticosteroid therapy to surgical excision in management of idiopathic granulomatous mastitis. Patients and Methods: This is a comparative study which was conducted at Ain-Shams University Hospital’s breast clinic on patients with idiopathic granulomatous mastitis from August 2015 till September 2018. Thirty patients were divided into 2 groups. Group (A) consistent of participants who received surgical management only. Group (B) includes patients who received corticosteroid therapy according to the severity of the cases then surgical Excision was done for the residual lesion. Follow up of the cases was done up to 1-2 years to document the recurrence rate and to assess the cosmetic outcome of both groups. Informed consent was obtained from all the cases included in the study. Results: The mean age of the affected women was 38.80 and 33.13 in group (A) and group (B), respectively and it wasn’t statistically different (p value = 0.099). The most common presenting symptom was a palpable mass in the breast (66.7% and 93.3%) in group (A) and group (B) respectively. Recurrence rate was higher in group (A) (40%) with no recurrence documented in group (B) however 2 cases were omitted from the study due to steroid noncompliance and complications. Cosmetic outcome was found to be excellent in 76.9% of group (B) and good in 53.3% of group (A). Conclusion: Systemic steroid with surgical resection is recommended as a treatment strategy for IGM as it shows less recurrence rate and less post- surgical scarring. Further larger studies are recommended for better awareness of IGM to improve its management in our country.

Keywords: granulomatous mastitis, breast, steroid

Medical Science, 2021, 25(110), 836-845

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