A descriptive study of chronic granulomatous mastitis in Central India

Authors

  • Bhupesh Harish Tirpude Department of Surgery, Government Medical College, Nagpur, Maharashtra, India
  • Ashwini Annamwar Department of Surgery, Government Medical College, Nagpur, Maharashtra, India
  • Raj Gajbhiye Department of Surgery, Government Medical College, Nagpur, Maharashtra, India
  • Gayatri Deshpande Department of Surgery, Government Medical College, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20222595

Keywords:

Chronic granulomatous mastitis, Breast cancer, Lump, Tuberculosis, Axillary lymph node, Biopsy, Antibiotic, Corticosteroid, Mastectomy

Abstract

Background: Chronic granulomatous mastitis is a rare benign breast condition that can mimic breast cancer. The present study was undertaken to assess the demographics, clinical presentation, etiology, diagnostic tools and management of patients with CGM.

Methods: This descriptive observational study was conducted in total 83 women who presented with breast lump with tenderness associated with fever for more than 4 weeks of duration in the Department of General Surgery at Tertiary Care Centre from June 2018 to December 2020.

Results: In all cases breast lump was chief complaint, of maximum (38.5%) had this illness since last 1 to 4 months. 48 patients had past history of tuberculosis. Axillary lymph node was enlarged in 24.1% and body temperature was raised in 57.8% of cases. Skins over the lump were presented with indurated with multiple pus discharging sinuses (50.6%) and palpable mass with erythema and ulcerative skin lesion (49.4%). On biopsy all the patients presented with granulomatous mastitis and on USG, hypoechoic mass was presents in all cases. Patients were managed medically by IV antibiotic and AKT (57.8%) and IV antibiotic with oral corticosteroid (42.2%). Incision and drainage were done in 74 cases while 8 required wide local excision and in 1 patient mastectomy was done.

Conclusions: The histopathology remains the optimal diagnostic tool. Corticosteroid therapy has been shown to be efficacious for CGM, but in the existence of many complications, surgical treatment has been first method of choice. We consider that wide local excision is the better treatment choice if possible.

Author Biographies

Bhupesh Harish Tirpude, Department of Surgery, Government Medical College, Nagpur, Maharashtra, India

Associate Professor , Department Of Surgery , GOvernment Medical College, Nagpur

Ashwini Annamwar, Department of Surgery, Government Medical College, Nagpur, Maharashtra, India

Associate Professor , Department Of Surgery , GOvernment Medical College, Nagpur

Raj Gajbhiye, Department of Surgery, Government Medical College, Nagpur, Maharashtra, India

Department Of Surgery , GOvernment Medical College, Nagpur

Gayatri Deshpande, Department of Surgery, Government Medical College, Nagpur, Maharashtra, India

Department Of Surgery , GOvernment Medical College, Nagpur

References

Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol. 1972;58(6):642-6.

Gautier N, Lalonde L, Tran-Thanh D. Chronic granulomatous mastitis: imaging, pathology and management. Eur J Radiol. 2013;82(4):e165-75.

Al-Khaffaf B, Knox F, Bundred NJ. Idiopathic granulomatous mastitis: a 25 year experience. J Am Coll Surg. 2008;206(2):269-73.

Patel RA, Strickland P, Sankara IR, Pinkston G, Many W, Rodriguez M. Idiopathic granulomatous mastitis: Case reports and review of literature. J Gen Intern Med. 2010;25:270-3.

Sheybani F, Sarvghad M, Naderi HR, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol. 2015;125:801-7

Topete, A, Carrasco O, Barrera G, Garzón J, Gutierrez E, Márquez C, et al. Granulomatous Mastitis: Incidence and Experience in a Mexican Institute. J Biosci Med. 2019;7:24-32.

Garcia-Rodiguez JA, Pattullo A. Idiopathic granulomatous mastitis: a mimicking disease in a pregnant woman: a case report. BMC Res Notes. 2013;6:95.

Kalaycı TÖ, Koruyucu MB, Apaydın M, Etit D, Varer M. Idiopathic Granulomatous Mastitis Associated with Erythema Nodosum. Balkan Med J. 2016;33(2):228-31.

Gurleyik G, Aktekin A, Aker F, Karagulle H, Saglamc A. Medical and Surgical Treatment of Idiopathic Granulomatous Lobular Mastitis: A Benign Inflammatory Disease Mimicking Invasive Carcinoma. J Breast Cancer. 2012;15(1):119-23.

Chabrol A. Mastite granulomateuse: problèmes diagnostiques et thérapeutiques”. Revue de Médecine Interne. 2008;29(110):1.

Manogna P, Dev B, Joseph LD, et al. Idiopathic granulomatous mastitis-our experience. Egypt J Radiol Nucl Med. 2020;51:15.

Linda J. Hovanessian larsen banafsheh peyvandi nancy klipfel edward grant geeta iyengar granulomatous lobular mastitis: imaging, diagnosis, and treatment. AJR. 2009;193:574-81.

Liu L, Fei Z, Liu XZS, Liyuan L, Yujuan X, Mingming G, et al. Granulomatous lobular mastitis: antituberculous treatment and outcome in 22 patients. Breast Care. 2018;13:359-63.

Fei Z, Li-Xiang Y, Zhong-Bing M, Zhi-Gang Y. Granulomatous lobular mastitis chronic diseases and translational medicine. Med Care. 2016;2:17-21.

Ergin AB, Cristofanilli M, Daw H, Tahan G, Gong Y. Recurrent granulomatous mastitis mimicking inflammatory breast cancer. BMJ Case Rep. 2011.

Conte AB, Barick A, Alaoui FZF, Sanoh AA, Jayi S, Soule HM, et al. Granulomatous mastitis: a descriptive study of 08 cases observed in the department of gynecology-obstetrics ii of the HASSAN II teaching hospital of fez. EC Gynaecol. 2021;10(4):30-4.

Sheybani F, Sarvghad M, Naderi HR, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol. 2015;125(4):801-7.

Salehi M, Salehi M, Kalbasi N, Hakamifard A, Salehi H, Salehi MM, et al. Corticosteroid and azithromycin in idiopathic granulomatous mastitis. Adv Biomed Res. 2017;6:8.

Xiaojia M, Xiaoli M, Chang Y. Different treatments for granulomatous lobular mastitis: a systematic review and meta-analysis. Breast Care. 2020;15:60-6.

Downloads

Published

2022-09-28

Issue

Section

Original Research Articles