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Published in: World Journal of Surgery 11/2015

01-11-2015 | Original Scientific Report

Topical Steroids Are Effective in the Treatment of Idiopathic Granulomatous Mastitis

Authors: Fatih Altintoprak, Taner Kivilcim, Omer Yalkin, Yener Uzunoglu, Zeynep Kahyaoglu, Osman Nuri Dilek

Published in: World Journal of Surgery | Issue 11/2015

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Abstract

Background

Idiopathic granulomatous mastitis (IGM) is a rare, benign, and chronic disease of the breast. Despite the various treatment approaches described for this disease, a gold standard treatment modality has not yet been defined. In this study, the effect of topical steroids was reviewed and assessed in patients with IGM.

Methods

The records of patients with IGM who were treated only with topical steroids were retrospectively reviewed. Patients were grouped as “completely healed,” “inadequately healed,” “stable,” “worsened,” or “recurred” if they had once healed but their symptoms returned. Patients whose skin changes were completely ameliorated were considered “completely healed.”

Results

All of the patients were women, and the average patient age was 35.7 years (range 24–48 years). During the average follow-up of 37.2 months (range 12–72 months) in patients who received only topical steroid treatment, recurrence was observed in three patients (3/28, 10.7 %), and no side effects or steroid-related complications occurred.

Conclusions

Topical steroids seem to be effective in the treatment of IGM characterized by skin changes. Prospective clinical studies would be useful in determining the clinical efficacy of topical steroids in the treatment of IGM.
Literature
1.
go back to reference Diesing D, Axt-Fliedner R, Hornung D et al (2004) Granulomatous mastitis. Arch Gynecol Obstet 269(4):233–236CrossRefPubMed Diesing D, Axt-Fliedner R, Hornung D et al (2004) Granulomatous mastitis. Arch Gynecol Obstet 269(4):233–236CrossRefPubMed
2.
go back to reference Bani-Hani KE, Yaghan RJ, Matalka II et al (2004) Idıopathic granulomatous mastitis: time to avoid unnecesary mastectomies. Breast J 10(4):318–322CrossRefPubMed Bani-Hani KE, Yaghan RJ, Matalka II et al (2004) Idıopathic granulomatous mastitis: time to avoid unnecesary mastectomies. Breast J 10(4):318–322CrossRefPubMed
3.
go back to reference Kessler E, Wolloch Y (1972) Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 58(6):642–646PubMed Kessler E, Wolloch Y (1972) Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 58(6):642–646PubMed
4.
go back to reference Heer R, Shrimankar J, Griffith CD (2003) Granulomatous mastitis can mimic breast cancer on clinical, radiological, or cytological examination: a cautionary tale. Breast 12(4):283–286CrossRefPubMed Heer R, Shrimankar J, Griffith CD (2003) Granulomatous mastitis can mimic breast cancer on clinical, radiological, or cytological examination: a cautionary tale. Breast 12(4):283–286CrossRefPubMed
5.
go back to reference Guven HE, Pak I, Oral S (2006) Granulomatous mastitis: surgical outcomes. J Coll Physicians Surg Pak 16(6):431–433PubMed Guven HE, Pak I, Oral S (2006) Granulomatous mastitis: surgical outcomes. J Coll Physicians Surg Pak 16(6):431–433PubMed
6.
go back to reference Asoglu O, Ozmen V, Karanlik H et al (2005) Feasibility of surgical management in patients with granulomatous mastitis. Breast J 11(2):108–114CrossRefPubMed Asoglu O, Ozmen V, Karanlik H et al (2005) Feasibility of surgical management in patients with granulomatous mastitis. Breast J 11(2):108–114CrossRefPubMed
7.
go back to reference Kok KY, Telisinqhe PU (2010) Granulomatous mastitis: presentation, treatment and outcome in 43 patients. Surgeon 8(4):197–201CrossRefPubMed Kok KY, Telisinqhe PU (2010) Granulomatous mastitis: presentation, treatment and outcome in 43 patients. Surgeon 8(4):197–201CrossRefPubMed
8.
go back to reference Ocal K, Dag A, Turkmenoglu O et al (2010) Granulomatous mastitis: clinical, pathologic features, and management. Breast J 16(2):176–182CrossRefPubMed Ocal K, Dag A, Turkmenoglu O et al (2010) Granulomatous mastitis: clinical, pathologic features, and management. Breast J 16(2):176–182CrossRefPubMed
9.
go back to reference Azlina AF, Ariza Z, Arni T et al (2003) Chronic granulomatous mastitis: diagnostic and therapeutic considerations. World J Surg 27(5):515–518CrossRefPubMed Azlina AF, Ariza Z, Arni T et al (2003) Chronic granulomatous mastitis: diagnostic and therapeutic considerations. World J Surg 27(5):515–518CrossRefPubMed
10.
go back to reference Yau FM, Macadam SA, Kuusk U et al (2010) The surgical management of granulomatous mastitis. Ann Plast Surg 64(1):9–16CrossRefPubMed Yau FM, Macadam SA, Kuusk U et al (2010) The surgical management of granulomatous mastitis. Ann Plast Surg 64(1):9–16CrossRefPubMed
11.
go back to reference DeHertogh DA, Rossof AH, Harris AA et al (1980) Prednisone management of granulomatous mastitis. N Eng J Med 303(14):799–800CrossRef DeHertogh DA, Rossof AH, Harris AA et al (1980) Prednisone management of granulomatous mastitis. N Eng J Med 303(14):799–800CrossRef
12.
go back to reference Fetveit T, Uqqerud R (1993) Granulomatous mastitis in a patient treated with prednisone. Tidsskr Nor Laegeforen 113(23):2906–2907PubMed Fetveit T, Uqqerud R (1993) Granulomatous mastitis in a patient treated with prednisone. Tidsskr Nor Laegeforen 113(23):2906–2907PubMed
13.
go back to reference Aldaqal SM (2004) Idiopathic granulomatous mastitis. Clinical presentation, radiological features and treatment. Saudi Med J 25(12):1884–1887PubMed Aldaqal SM (2004) Idiopathic granulomatous mastitis. Clinical presentation, radiological features and treatment. Saudi Med J 25(12):1884–1887PubMed
14.
go back to reference Katz U, Molad Y, Ablin J et al (2007) Chronic idiopathic granulomatous mastitis. Ann Y Acad Sci 1108:603–608CrossRef Katz U, Molad Y, Ablin J et al (2007) Chronic idiopathic granulomatous mastitis. Ann Y Acad Sci 1108:603–608CrossRef
15.
go back to reference Erozgen F, Ersoy YE, Akaydin M et al (2010) Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Res Treat 123(2):447–452CrossRefPubMed Erozgen F, Ersoy YE, Akaydin M et al (2010) Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Res Treat 123(2):447–452CrossRefPubMed
16.
go back to reference Kim J, Tymms KE, Buckingham JM (2003) Methotrexate in the management of granulomatous mastitis. ANZ J Surg 73(4):247–249CrossRefPubMed Kim J, Tymms KE, Buckingham JM (2003) Methotrexate in the management of granulomatous mastitis. ANZ J Surg 73(4):247–249CrossRefPubMed
17.
go back to reference Maffini F, Baldini F, Bassi F et al (2009) Systemic therapy as a first choice treatment for idiopathic granulomatous mastitis. J Cutan Pathol 36(6):689–691CrossRefPubMed Maffini F, Baldini F, Bassi F et al (2009) Systemic therapy as a first choice treatment for idiopathic granulomatous mastitis. J Cutan Pathol 36(6):689–691CrossRefPubMed
18.
go back to reference Su FH, Liu SC, Suen JH et al (2005) Idiopathic granulomatous mastitis: a case successfully treated with a minimum dose of a steroid. Chang Gung Med J 28(6):431–435PubMed Su FH, Liu SC, Suen JH et al (2005) Idiopathic granulomatous mastitis: a case successfully treated with a minimum dose of a steroid. Chang Gung Med J 28(6):431–435PubMed
19.
go back to reference Tuli R, O’Hara BJ, Hines J et al (2007) Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: a case report and review of the literature. Int Semin Surg Oncol 4:21PubMedCentralCrossRefPubMed Tuli R, O’Hara BJ, Hines J et al (2007) Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: a case report and review of the literature. Int Semin Surg Oncol 4:21PubMedCentralCrossRefPubMed
20.
go back to reference Chrousos GP (2001) Glucocorticoid therapy. In: Felig P, Frohman L (eds) Endocrinology and metabolism, 4th edn. McGraw-Hill, Incorporated, New York, pp 609–612 Chrousos GP (2001) Glucocorticoid therapy. In: Felig P, Frohman L (eds) Endocrinology and metabolism, 4th edn. McGraw-Hill, Incorporated, New York, pp 609–612
21.
go back to reference Peppa M, Krania M, Reptis SA (2011) Hypertension and other morbidities with Cushing’s syndrome associated with corticosteroids: a review. Integr Blood Press Control 4:7–16PubMedCentralCrossRefPubMed Peppa M, Krania M, Reptis SA (2011) Hypertension and other morbidities with Cushing’s syndrome associated with corticosteroids: a review. Integr Blood Press Control 4:7–16PubMedCentralCrossRefPubMed
22.
go back to reference Akbulut S, Yilmaz D, Bakir S (2011) Methotrexate in the management of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases. Breast J 17(6):661–668CrossRefPubMed Akbulut S, Yilmaz D, Bakir S (2011) Methotrexate in the management of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases. Breast J 17(6):661–668CrossRefPubMed
23.
go back to reference Raj N, Macmillan RD, Ellis IO et al (2004) Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology 43(8):1055–1056CrossRefPubMed Raj N, Macmillan RD, Ellis IO et al (2004) Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology 43(8):1055–1056CrossRefPubMed
24.
go back to reference Joly P, Roujeau JC, Benichou J, Bullous Diseases French Study Group et al (2002) A comparison of oral and topical corticosteroids in patients with bullous pemphidoid. N Eng J Med 346(5):321–327CrossRef Joly P, Roujeau JC, Benichou J, Bullous Diseases French Study Group et al (2002) A comparison of oral and topical corticosteroids in patients with bullous pemphidoid. N Eng J Med 346(5):321–327CrossRef
25.
go back to reference Buys LM (2007) Treatment options for atopic dermatitis. Am Fam Physician 75(4):523–528PubMed Buys LM (2007) Treatment options for atopic dermatitis. Am Fam Physician 75(4):523–528PubMed
26.
go back to reference Bewley A, Dermatology Working Group (2008) Expert consensus: time for a change in the way we advise our patients to use topical. Br J Dermatol 158(5):917–920CrossRefPubMed Bewley A, Dermatology Working Group (2008) Expert consensus: time for a change in the way we advise our patients to use topical. Br J Dermatol 158(5):917–920CrossRefPubMed
28.
go back to reference Atak T, Sagiroglu J, Eren T et al (2015) Strategies to treat idiopathic granulomatous mastitis; retrospective analysis of 40 patients. Breast Dis 35(1):19–24PubMed Atak T, Sagiroglu J, Eren T et al (2015) Strategies to treat idiopathic granulomatous mastitis; retrospective analysis of 40 patients. Breast Dis 35(1):19–24PubMed
29.
go back to reference Salesi M, Karimifar M, Salimi F et al (2011) A case of granulomatous mastitis with erythema nodosum and arthritis. Rheumatol Int 31(8):1093–1095CrossRefPubMed Salesi M, Karimifar M, Salimi F et al (2011) A case of granulomatous mastitis with erythema nodosum and arthritis. Rheumatol Int 31(8):1093–1095CrossRefPubMed
30.
go back to reference Hanifin J, Gupta AK, Rajagopalan R (2002) Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients. Br J Dermatol 147(3):528–537CrossRefPubMed Hanifin J, Gupta AK, Rajagopalan R (2002) Intermittent dosing of fluticasone propionate cream for reducing the risk of relapse in atopic dermatitis patients. Br J Dermatol 147(3):528–537CrossRefPubMed
31.
go back to reference Lai EC, ChanWC Ma TK et al (2005) The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 11(6):454–456CrossRefPubMed Lai EC, ChanWC Ma TK et al (2005) The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 11(6):454–456CrossRefPubMed
34.
go back to reference Gunduz Y, Altintoprak F, Tatli Ayhan L et al (2014) Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation. Breast J 20(6):586–591CrossRefPubMed Gunduz Y, Altintoprak F, Tatli Ayhan L et al (2014) Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation. Breast J 20(6):586–591CrossRefPubMed
Metadata
Title
Topical Steroids Are Effective in the Treatment of Idiopathic Granulomatous Mastitis
Authors
Fatih Altintoprak
Taner Kivilcim
Omer Yalkin
Yener Uzunoglu
Zeynep Kahyaoglu
Osman Nuri Dilek
Publication date
01-11-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 11/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3147-9

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