Idiopathic Granulomatous Mastitis; Radio-pathologic findings and Grading based on Clinical Presentation and treatment outcome in 224 patients IGM; Radio-pathologic and grading

Forough Yazdanian (1), Mahtab Vasigh (2), Sanaz Zand (3), Farid Azmoudeh Ardalan (4), Maryam Rahmani (5), Negar Mashoori (6), Soheil Saadat (7), Ahmad Elahi (8)
(1) Research Department, Kaviani Breast Disease Institute, Tehran, Iran., Iran, Islamic Republic of,
(2) Department of Surgery, Tehran University of Medical Sciences. Tehran, Iran, Iran, Islamic Republic of,
(3) Department of Surgery, Tehran University of Medical Sciences. Research Department, Kaviani Breast Disease Institute, Tehran, Iran, Iran, Islamic Republic of,
(4) Department of Pathology, Tehran University of Medical Science, Tehran, Iran., Iran, Islamic Republic of,
(5) Department of Radiology, Tehran University of Medical Science, Tehran, Iran; Advanced Diagnostic and Intervention Research Centre, Tehran University of Medical Sciences, Tehran, Iran, Iran, Islamic Republic of,
(6) Department of Surgery, Tehran University of Medical Science, Tehran, Iran., Iran, Islamic Republic of,
(7) Department of Emergency Medicine, University of California, Irvine, CA, USA., United States,
(8) Breast Disease Research Center, Tehran University of Medical Science, Tehran, Iran., Iran, Islamic Republic of

Abstract

Background: Idiopathic granulomatous mastitis (IGM) is a rare inflammatory disease of the breast with unknown etiology. Clinico-radiologic findings can mimic breast cancer. Further pathologic evaluation to rule out malignancy is mandatory. Recognizing the severity of the disease is crucial to choosing the most effective therapeutic modality. The aim of this study is to evaluate clinical and radio-pathologic features of IGM, and the treatment outcome in a large series of IGM patients in Iran.
Methods: The retrospective charts of 243 patients suspicious of IGM, between December 2007 and September 2017 were reviewed. Patients with confirmed diagnosis of IGM were classified into four grades of severity. Demographic information, clinical and radio-pathologic findings, severity and treatment outcomes were collected.
Results: Overall, 224 patients were confirmed to have IGM. Breast mass and erythema were the most common clinical findings. Mammographic findings mimicked malignancy in 34%. Lobulo-centric non-caseating granulomas were the most common pathologic finding. Also, 61.5% of the patients had mild to moderate symptoms and 49.5% of them recovered completely by observation. In addition, 53 (25.9%) patients had severe symptoms and 30.8% of them were resistant to treatment.
Conclusion: IGM is a diagnostic challenge. Its diagnosis is based on exclusion and a close cooperation between the clinician, the radiologist and the pathologist. Mild to moderate cases can be managed conservatively; however, severe cases may need further aggressive medical or surgical treatments.

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Authors

Forough Yazdanian
Mahtab Vasigh
mahtabvasigh@yahoo.com (Primary Contact)
Sanaz Zand
Farid Azmoudeh Ardalan
Maryam Rahmani
Negar Mashoori
Soheil Saadat
Ahmad Elahi
1.
Yazdanian F, Vasigh M, Zand S, Azmoudeh Ardalan F, Rahmani M, Mashoori N, Saadat S, Elahi A. Idiopathic Granulomatous Mastitis; Radio-pathologic findings and Grading based on Clinical Presentation and treatment outcome in 224 patients : IGM; Radio-pathologic and grading. Arch Breast Cancer [Internet]. 2022 May 15 [cited 2024 Apr. 22];9(3-SI):293-300. Available from: https://archbreastcancer.com/index.php/abc/article/view/577

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