J Korean Surg Soc.  2013 Jul;85(1):1-6.

Experience of treatment of patients with granulomatous lobular mastitis

• Hur SM
• Cho DH
• Lee SK
• Choi MY
• Bae SY
• Koo MY
• Kim S
• Choe JH
• Kim JH
• Kim JS
• Nam SJ
• Yang JH
• Lee JE

Abstract

PURPOSE
To present the author's experience with various treatment methods of granulomatous lobular mastitis (GLM) and to determine effective treatment methods of GLM.
METHODS
Fifty patients who were diagnosed with GLM were classified into five groups based on the initial treatment methods they underwent, which included observation (n = 8), antibiotics (n = 3), steroid (n = 13), drainage (n = 14), and surgical excision (n = 12). The treatment processes in each group were examined and their clinical characteristics, treatment processes, and results were analyzed respectively.
RESULTS
Success rates with each initial treatment were observation, 87.5%; antibiotics, 33.3%; steroids, 30.8%; drainage, 28.6%; and surgical excision, 91.7%. In most cases of observation, the lesions were small and the symptoms were mild. A total of 23 patients underwent surgical excision during treatment. Surgical excision showed particularly fast recovery, high success rate (90.3%) and low recurrence rate (8.7%).
CONCLUSION
The clinical course of GLM is complex and the outcome of each treatment type are variable. Surgery may play an important role when a lesion is determined to be mass-forming or appears localized as an abscess pocket during breast examination or imaging study.

Keyword

Breast; Granulomatous mastitis; Treatment; Excision

MeSH Terms

Abscess
Anti-Bacterial Agents
Breast
Drainage
Female
Granulomatous Mastitis
Humans
Mastitis
Recurrence
Steroids
Anti-Bacterial Agents
Steroids

Figure

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  Fig. 1 Process of antibiotic treatment of granulomatous lobular mastitis. F/U, follow-up.

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  Fig. 2 Process of steroid treatment of granulomatous lobular mastitis.

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  Fig. 3 Process of drainage treatment of granulomatous lobular mastitis. F/U, follow-up.

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  Fig. 4 A 37 year old woman with granulomatous lobular mastitis mimicking breast carcinoma. (A) Mammography shows a malignant looking mass (arrow) in the left upper outer quadrant. (B) Ultrasonography shows an irregular shaped hypoechoic mass (about 1.5 cm). (C) Magnetic resonance imaging shows a lobulated rim enhancing mass (arrow) with an intermediate concern level of malignancy.

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  Fig. 5 Process of surgical excision of granulomatous lobular mastitis.

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