Granulomatous Mastitis: A Ten-Year Experience at a University Hospital

Area of Science:

• General Surgery
• Pathology
• Radiology

Background:

• Granulomatous mastitis presents diagnostic and therapeutic challenges.
• Understanding its clinical, radiologic, and pathologic features is crucial for effective management.

Purpose of the Study:

• To define the clinical, radiologic, and pathologic characteristics of patients with granulomatous mastitis.
• To evaluate medical and surgical treatment outcomes for granulomatous mastitis.
• To develop a clinical algorithm for the diagnosis and treatment of granulomatous mastitis.

Main Methods:

• Retrospective analysis of 93 patients diagnosed with granulomatous mastitis between 2001 and 2010.
• Inclusion of demographic data, clinical presentation, imaging findings, laboratory results, and treatment outcomes.
• Histopathologic confirmation of diagnosis for all patients.

Main Results:

• 93 patients (91 female, 2 male) with a mean age of 34.4 years were evaluated.
• 73 patients had idiopathic granulomatous lobular mastitis; 20 had specific types (18 tuberculosis, 1 alveolar echinococcosis, 1 silk reaction).
• Previous treatments (antibiotics, anti-inflammatory, debridement) showed poor clinical response.

Conclusions:

• Empiric antibiotic therapy and drainage are insufficient for idiopathic granulomatous mastitis; complete excision is necessary.
• Corticosteroid therapy may be beneficial in selected cases.
• Tuberculous mastitis requires antitubercular therapy and abscess drainage, with wide excision for recurrent disease.