Gustavo Fernández , Ingrid Sehringer , Eliana Blanco , Mariela Fernández , Darío Mata
{"title":"Mastitis granulomatosa: experiencia diagnóstica y terapéutica multidisciplinaria del Hospital Argerich de Buenos Aires","authors":"Gustavo Fernández , Ingrid Sehringer , Eliana Blanco , Mariela Fernández , Darío Mata","doi":"10.1016/j.senol.2023.100547","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Granulomatous mastitis is a chronic inflammatory disease that presents as a painful breast mass, associated with abscesses and fistulas, which can mimic carcinoma. Etiology is still unclear, and an autoimmune response related to <em>Corynebacterium</em> is postulated. There are no diagnostic guidelines or therapeutic algorithms. In our study we analyzed the clinical presentations, images, cultures, and pathological findings together with the treatments, results, and evolution.</p></div><div><h3>Material and methods</h3><p>We carried out a descriptive, retrospective, and observational study of patients diagnosed with granulomatous mastitis treated in our hospital in the period 2017-2022.</p></div><div><h3>Results</h3><p>51 women. Average age 38.1 years. Pregnancies and Lactation 88.2%. Clinic: Abscessed and/or fistulized palpable mass 74.5%, painful palpable mass 13.8%. Asymptomatic mass 11.7%. Erythema Nodosum 11.7% BIRADS images 4/5: 82.3%. Average size: 3.54 cm. Pathology: Cystic vacuoles associated with <em>Corynebacterium</em> in 24 biopsies (47.1%). Bacteriology: positive cultures for <em>Corynebacterium</em> in 13 of 47 samples (27.6%). Treatment: antibiotic therapy 92.1%, immunosuppression 78.4%, surgical treatment 60.7%. Mean time of immunosuppression with corticosteroids 7.09 months and with methotrexate 9.27 months. Complications: 9.8% Aesthetic sequelae: 39.2% Disease-free time: 14.04 months. Recurrences: 13.7%.</p></div><div><h3>Conclusions</h3><p>The bacteriological and pathological search for <em>Corynebacterium</em> and a patient tailor made multidisciplinary approach is essential to achieve therapeutic success.</p></div>","PeriodicalId":38058,"journal":{"name":"Revista de Senologia y Patologia Mamaria","volume":"37 1","pages":"Article 100547"},"PeriodicalIF":0.2000,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista de Senologia y Patologia Mamaria","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0214158223000798","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Granulomatous mastitis is a chronic inflammatory disease that presents as a painful breast mass, associated with abscesses and fistulas, which can mimic carcinoma. Etiology is still unclear, and an autoimmune response related to Corynebacterium is postulated. There are no diagnostic guidelines or therapeutic algorithms. In our study we analyzed the clinical presentations, images, cultures, and pathological findings together with the treatments, results, and evolution.
Material and methods
We carried out a descriptive, retrospective, and observational study of patients diagnosed with granulomatous mastitis treated in our hospital in the period 2017-2022.
Results
51 women. Average age 38.1 years. Pregnancies and Lactation 88.2%. Clinic: Abscessed and/or fistulized palpable mass 74.5%, painful palpable mass 13.8%. Asymptomatic mass 11.7%. Erythema Nodosum 11.7% BIRADS images 4/5: 82.3%. Average size: 3.54 cm. Pathology: Cystic vacuoles associated with Corynebacterium in 24 biopsies (47.1%). Bacteriology: positive cultures for Corynebacterium in 13 of 47 samples (27.6%). Treatment: antibiotic therapy 92.1%, immunosuppression 78.4%, surgical treatment 60.7%. Mean time of immunosuppression with corticosteroids 7.09 months and with methotrexate 9.27 months. Complications: 9.8% Aesthetic sequelae: 39.2% Disease-free time: 14.04 months. Recurrences: 13.7%.
Conclusions
The bacteriological and pathological search for Corynebacterium and a patient tailor made multidisciplinary approach is essential to achieve therapeutic success.