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Azzam MI, Alnaimat F, Al-Nazer MW, Awad H, Odeh G, Al-Najar M, Alsayed S, El-Asir L, Addasi R, Melhem JM, Sweiss NJ. Idiopathic granulomatous mastitis: clinical, histopathological, and radiological characteristics and management approaches. Rheumatol Int 2023; 43:1859-1869. [PMID: 37347273 DOI: 10.1007/s00296-023-05375-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/15/2023] [Indexed: 06/23/2023]
Abstract
Idiopathic Granulomatous Mastitis (IGM) is an infrequent, benign breast disease that primarily affects women during their childbearing years and can be mistaken for breast cancer. This study aimed to review the clinical, radiological, and histopathological findings of patients with IGM in addition to management and outcome. Retrospective cross-sectional study of biopsy-confirmed IGM at an academic medical center and a private hospital in Amman, Jordan. Fifty-four patients were included, with a mean age of 37.0 ± 9.04 years, mostly presenting with a breast lump (n = 52, 96.3%) and breast pain (n = 45 patients, 84.9%). Approximately half of the patients (51.9%) were parous, and 50% had breastfed for an average duration of 30.37 ± 22.38 months. Most of the patients had either solitary or multiple abscesses on breast ultrasound. Histopathological analysis (n = 35) showed mostly either moderate inflammation (n = 16, 45.7%) or severe inflammation (n = 14, 40%). Two-thirds of the patients underwent surgical interventions at the time of diagnosis, mostly incision and drainage (n = 16, 29%) or surgical excision (n = 7, 13%), and no mastectomies were performed. The most common medical treatment included a combination of antibiotics, corticosteroids, and methotrexate (n = 21, 38.8%). After follow-up, 31 patients remained in remission, 3 experienced relapses, and 3 had a chronic course. The use of corticosteroids was significantly associated with remission (p = 0.035). The presentation and demographics of IGM patients in Jordan were consistent with the existing literature. Prospective research is needed to explore different treatment options and disease outcomes.
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Affiliation(s)
- Muayad I Azzam
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Fatima Alnaimat
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, 11942, Jordan.
| | | | - Heyam Awad
- Department of Pathology, School of Medicine, University of Jordan, Amman, 11942, Jordan
| | - Ghada Odeh
- Department of General Surgery, School of Medicine, University of Jordan, Amman, 11942, Jordan
| | - Mahasen Al-Najar
- Department of Radiology and Nuclear Medicine, School of Medicine, University of Jordan, Amman, 11942, Jordan
| | - Suzan Alsayed
- Department of Rheumatology, Abdali Hospital, Amman, Jordan
| | - Layal El-Asir
- Women's Health and Breast Center, Abdali Hospital, Amman, Jordan
| | - Rami Addasi
- Department of General Surgery, School of Medicine, University of Jordan, Amman, 11942, Jordan
| | - Jamal Masad Melhem
- Department of General Surgery, School of Medicine, University of Jordan, Amman, 11942, Jordan
| | - Nadera J Sweiss
- Division of Rheumatology, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA
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Harvey JA. Using a "Wide Lens". JOURNAL OF BREAST IMAGING 2023; 5:101-103. [PMID: 38416940 DOI: 10.1093/jbi/wbad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Indexed: 03/01/2024]
Affiliation(s)
- Jennifer A Harvey
- University of Rochester, Department of Imaging Sciences, Rochester, NY, USA
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