Correlación clínico-patológica para el diagnóstico de mastitis crónica tratada con cirugía

Objectives

Chronic mastitis (CM) frequently relapse without an identified etiology, although they have been treated with a spectrum of treatments that includes different antibiotics, anti-inflammatories and surgery, more or less aggressive depending on their extension. The objective is to investigate if clinicopathological correlation is useful in the diagnosis of CM.

Material and methods

A descriptive, observational and retrospective study of a series of 100 patients (n = 100) diagnosed during ten years with CM is presented. Anamnesis, clinical debut, physical examination, imaging techniques, type of surgery, number of recurrences, histological inflammatory pattern data, complementary tests including microbiological study and serology, number of biopsies, number of consultation visits and time until final diagnosis are evaluated. Finally, the average of cases diagnosed by clinicopathological correlation is determined.

Results

Results of surgical interventions, clinical and histopathological findings, microbiology and serology are included in tables. Clinicopathological correlation achieved etiopathogenic diagnosis in 99% of the cases including chronic suppurative galactophoritis (91%); vasculitis (3%), two of them compatible with granulomatosis with polyangiitis; idiopathic granulomatous mastitis (2%) and non-diabetic lymphocytic lobulillitis (3%). Thirty-eight percent of the cases presented recurrences. The mean time to definitive diagnosis was 20.02 (standard deviation = 49.87) weeks. The average number of visits to outpatient clinics was 15.35 (standard deviation = 14.97).

Conclusions

Clinicopathological correlation improves the diagnosis of CM, specially relapsed and without an identified etiology, although it may take a long time.