Skip to main content

Advertisement

SpringerLink
Log in

Delayed breast reconstruction in idiopathic granulomatous mastitis

  • Original Paper
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Idiopathic granulomatous mastitis is an exceptionally rare, chronic benign inflammatory disease of the breast, more common in developing countries and infrequently seen bilaterally. The symptoms can mimic many other breast conditions, including inflammatory breast carcinoma, and the diagnosis is one of exclusion. The management includes non-surgical treatments, such as broad spectrum antibiotics, steroids and methotrexate, and surgical options, comprising of wide local excision and even simple mastectomy.

Methods

The case notes of patients with idiopathic granulomatous mastitis referred to our Breast Unit were reviewed and data was collected on patients demographics, medical and surgical treatments and subsequent outcomes.

Results

Four patients were treated in our unit, all Caucasian women, three of whom were bilateral cases. Three of the patients were reconstructed using oncoplastic techniques whilst the fourth patient awaits reonstruction.

Conclusions

Oncoplastic breast reconstructive techniques play a fundamental role in the management of these patients, as they give the surgeon the freedom to perform a wider resection, thus reducing the rate of recurrence, whilst at the same time, knowing that there are reconstructive options to restore any breast aesthetics. As such, the value of a multidisciplinary team cannot be underestimated.

Level of Evidence: Level V, therapeutic study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Kessler E, Wolloch Y (1972) Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 58(6):642–646

    Article  CAS  PubMed  Google Scholar 

  2. Kim J, Tymms KE, Buckingham JM (2003) Methotrexate in the management of granulomatous mastitis. ANZ J Surg 73(4):247–249

    Article  PubMed  Google Scholar 

  3. Erhan Y, Veral A, Kara E, Özdemir N, Kapkac M, Özdedeli E, Yilmaz R, Koyuncu A, Erhan Y, Özbal O (2000) A clinicopthologic study of a rare clinical entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast 9(1):52–56

    Article  CAS  PubMed  Google Scholar 

  4. Taghizadeh R, Shelley OP, Chew BK, Weiler-Mithoff EM (2007) Idiopathic granulomatous mastitis: surgery, treatment, and reconstruction. Breast J 13(5):509–513

    Article  PubMed  Google Scholar 

  5. Ahmed YS, Abd El Maksoud W (2016) Evaluation of therapeutic mammoplasty techniques in the surgical management of female patients with idiopathic granulomatous mastitis with mild to moderate inflammatory symptoms in terms of recurrence and patients' satisfaction. Breast Dis 36(1):37–45

    Article  PubMed  Google Scholar 

  6. Hladik M, Schoeller T, Ensat F, Wechselberger G (2011) Idiopathic granulomatous mastitis: successful treatment by mastectomy and immediate breast reconstruction. J Plast Reconstr Aesthet Surg 64(12):1604–1607

    Article  PubMed  Google Scholar 

  7. Bani-Hani KE, Yaghan RJ, Matalka II, Shatnawi NJ (2004) Idiopathic granulomatous mastitis: time to avoid unnecessary mastectomies. Breast J 10(4):318–322

    Article  PubMed  Google Scholar 

  8. Going JJ, Anderson TJ, Wilkinson S, Chetty U (1987) Granulomatous lobular mastitis. J Clin Pathol 40(5):535–540

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Centers for Disease, C. and Prevention (2009) Idiopathic granulomatous mastitis in Hispanic women - Indiana, 2006-2008. MMWR Morb Mortal Wkly Rep 58(47):1317–1321

    Google Scholar 

  10. Ahmed R, Sultan F (2006) Granulomatous mastitis: a review of 14 cases. J Ayub Med Coll Abbottabad 18(1):52–54

    PubMed  Google Scholar 

  11. Kayahan M, Kadioglu H, Muslumanoglu M (2012) Management of Patients with granulomatous mastitis: analysis of 31 cases. Breast Care (Basel) 7(3):226–230

    Article  Google Scholar 

  12. Yabanoglu H et al (2015) A comparative study of conservative versus surgical treatment protocols for 77 patients with idiopathic granulomatous mastitis. Breast J 21(4):363–369

    Article  PubMed  Google Scholar 

  13. Sheybani F, Sarvghad MR, Naderi HR, Gharib M (2015) Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol 125(4):801–807

    Article  CAS  PubMed  Google Scholar 

  14. Oran ES, Gürdal SÖ, Yankol Y, Öznur M, Calay Z, Tunacı M, Soybir GR (2013) Management of idiopathic granulomatous mastitis diagnosed by core biopsy: a retrospective multicenter study. Breast J 19(4):411–418

    Article  PubMed  Google Scholar 

  15. Gurleyik G, Aktekin A, Aker F, Karagulle H, Saglamc A (2012) Medical and surgical treatment of idiopathic granulomatous lobular mastitis: a benign inflammatory disease mimicking invasive carcinoma. J Breast Cancer 15(1):119–123

    Article  PubMed  PubMed Central  Google Scholar 

  16. Schelfout K, Tjalma WA, Cooremans ID, Coeman DC, Colpaert CG, Buytaert PM (2001) Observations of an idiopathic granulomatous mastitis. Eur J Obstet Gynecol Reprod Biol 97(2):260–262

    Article  CAS  PubMed  Google Scholar 

  17. Taylor GB et al (2003) A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology 35(2):109–119

    PubMed  Google Scholar 

  18. Altintoprak F et al (2013) Idiopathic granulomatous mastitis: an autoimmune disease? Sci World J 2013:148727

    Google Scholar 

  19. Al-Khaffaf B, Knox F, Bundred NJ (2008) Idiopathic granulomatous mastitis: a 25-year experience. J Am Coll Surg 206(2):269–273

    Article  PubMed  Google Scholar 

  20. Imoto S et al (1997) Idiopathic granulomatous mastitis: case report and review of the literature. Jpn J Clin Oncol 27(4):274–277

    Article  CAS  PubMed  Google Scholar 

  21. Uysal E, Soran A, Sezgin E, Granulomatous Mastitis Study Group (2018) Factors related to recurrence of idiopathic granulomatous mastitis: what do we learn from a multicentre study? ANZ J Surg 88(6):635–639

    Article  PubMed  Google Scholar 

  22. Asoglu O, Ozmen V, Karanlik H, Tunaci M, Cabioglu N, Igci A, Selcuk UE, Kecer M (2005) Feasibility of surgical management in patients with granulomatous mastitis. Breast J 11(2):108–114

    Article  PubMed  Google Scholar 

  23. Ozel L et al (2012) Granulomatous mastitis: is it an autoimmune disease? Diagnostic and therapeutic dilemmas. Surg Today 42(8):729–733

    Article  CAS  PubMed  Google Scholar 

  24. Cserni G, Szajki K (1999) Granulomatous lobular mastitis following drug-induced galactorrhea and blunt trauma. Breast J 5(6):398–403

    Article  PubMed  Google Scholar 

  25. Lin CH, Hsu CW, Tsao TY, Chou J (2012) Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia. Diagn Pathol 7:2

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Sheybani F, Naderi HR, Gharib M, Sarvghad MR, Mirfeizi Z (2016) Idiopathic granulomatous mastitis: long-discussed but yet-to-be-known. Autoimmunity 49(4):236–239

    Article  CAS  PubMed  Google Scholar 

  27. Renshaw AA, Derhagopian RP, Gould EW (2011) Cystic neutrophilic granulomatous mastitis: an underappreciated pattern strongly associated with gram-positive bacilli. Am J Clin Pathol 136(3):424–427

    Article  PubMed  Google Scholar 

  28. Yu HJ, Deng H, Ma J, Huang SJ, Yang JM, Huang YF, Mu XP, Zhang L, Wang Q (2016) Clinical metagenomic analysis of bacterial communities in breast abscesses of granulomatous mastitis. Int J Infect Dis 53:30–33

    Article  PubMed  Google Scholar 

  29. Lai EC et al (2005) The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 11(6):454–456

    Article  PubMed  Google Scholar 

  30. Al-Jarrah A et al (2013) Idiopathic granulomatous mastitis: diagnostic strategy and therapeutic implications in Omani patients. Sultan Qaboos Univ Med J 13(2):241–247

    Article  PubMed  PubMed Central  Google Scholar 

  31. Akcan A, Akyıldız H, Deneme MA, Akgun H, Arıtas Y (2006) Granulomatous lobular mastitis: a complex diagnostic and therapeutic problem. World J Surg 30(8):1403–1409

    Article  PubMed  Google Scholar 

  32. Baslaim MM, Khayat HA, Al-Amoudi SA (2007) Idiopathic granulomatous mastitis: a heterogeneous disease with variable clinical presentation. World J Surg 31(8):1677–1681

    Article  PubMed  Google Scholar 

  33. Atak T, Sagiroglu J, Eren T, Ali Özemir İ, Alimoglu O (2015) Strategies to treat idiopathic granulomatous mastitis: retrospective analysis of 40 patients. Breast Dis 35(1):19–24

    Article  CAS  PubMed  Google Scholar 

  34. Neel A, Hello M, Cottereau A, Graveleau J, de Faucal P, Costedoat-Chalumeau N, Rondeau-Lutz M, Lavigne C, Chiche L, Hachulla E, Seiberras S, Cabane J, Tournemaine N, Hamidou M (2013) Long-term outcome in idiopathic granulomatous mastitis: a western multicentre study. QJM 106(5):433–441

    Article  CAS  PubMed  Google Scholar 

  35. Asgeirsson KS, Rasheed T, McCulley SJ, Macmillan RD (2005) Oncological and cosmetic outcomes of oncoplastic breast conserving surgery. Eur J Surg Oncol 31(8):817–823

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Thanks to Dr. Shoba Abraham, FRCP, Consultant Pathologist, The Northumbria Breast Unit.

Author information

Authors and Affiliations

  1. The Northumbria Breast Unit, Wansbeck Hospital, Ashington, NE63 9JJ, UK

    Neil R. McLean, Magdi K. Youssef & Gary Bristow

  2. University Hospitals Bristol Foundation NHS Trust, Bristol, BS2 8HW, UK

    Shaheel Chummun

Authors
  1. Neil R. McLean
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shaheel Chummun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Magdi K. Youssef
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gary Bristow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shaheel Chummun.

Ethics declarations

Funding

No funding was available for this review.

Conflict of interest

Author A and Author B declare that they have no conflict of interest with any person and/or organisations that can bias the outcome of the work submitted.

Ethical approval

The study was registered with the research department.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McLean, N.R., Chummun, S., Youssef, M.K. et al. Delayed breast reconstruction in idiopathic granulomatous mastitis. Eur J Plast Surg 42, 243–249 (2019). https://doi.org/10.1007/s00238-018-1474-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-018-1474-4

Keywords

Search

Navigation