الفهرس 
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Abstract
Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of the breast. The aetiology of IGM is not fully understood. However, autoimmune diseases, hormone irregularities, local immune response to trauma, local irritants, undetected organisms, viruses, hyperprolactinemia, diabetes, α-1-antitrypsin deficiency, smoking, ductal ectasis and oral contraceptive use have been blamed as the aetiology
The treatment of IGM is still a debate. Currently, there is no universally accepted treatment strategy. Local and systemic corticosteroids and antibiotics are the most frequently used agents in the medical treatment. However, successful results have been reported with agents, such as methotrexate, azathioprine, glucocorticoids, bromocriptine and colchicine.
Surgical treatment of IGM includes abscess drainage, local and wide excisions, or mastectomy. Better outcomes have been reported with steroid addition to the surgical treatment. The treatment of IGM is frequently complicated by difficulty in recognizing and diagnosing the disease, lack of an optimal treatment modality, prolonged treatment durations and high recurrence rates.
The current study was conducted over two years duration to assess the incidence, diagnosis and treatment of idiopathic granulomatous
mastitis. Fifteen women were enrolled with mean age was 43.20 ± 5.05 years with range between 36 and 56 years. Mean body mass index was 25.60 ± 4.09 (kg/m2). Only four women had history of oral contraception.
Mean duration of symptoms 2.46 ± 0.84 (months) with range between one and four months. Palpable mass was present in 13 (86.7%) patients with mean size was 4.06 ± 0.79 mm. Our study found that 11 (73.3%), 7 (46.7%) and 4 (26.7%) patients had irregular mass, abscess and parenchymal heterogeneity, respectively.
In our study, the majority (60%) of patients were managed with surgery plus steroid therapy while 3 (20%) patients treated with surgery alone and another 3 (20%) patients received steroid therapy alone. Mean time to resolution was 5.13 ± 0.64 months. Only two patients suffered from recurrent after 12 months; one patient received surgery alone and the other was managed with steroid therapy alone.
Based on the current study, breast mass with associated inflammatory signs in young patients is suggestive of granulomatous mastitis. It is essential to differentiate IGM from breast carcinoma. Due to the limited value of radiology, preoperative histopathologic confirmation by trucut biopsy is an important step in planning treatment for patients with IGM.
Although there is no consensus on the optimal treatment, surgical excision or steroid therapy is applied as a first-line therapy. Treatment is designated according to disease dimension, severity of the symptoms, and the patient’s health and treatment preferences. Because of its tendency to recur, close follow-up of patients with IGM is essential.