Differential diagnosis in idiopathic granulomatous mastitis and tuberculous mastitis

Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of unknown etiology. The diagnosis of IGM requires that other granulomatous lesions in the breast be excluded. Tuberculous mastitis (TM) is also an uncommon disease that is often difficult to differentiate from IGM. The p...

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Bibliographic Details
Published in:	Journal of breast cancer Vol. 15; no. 1; pp. 111 - 118
Main Authors:	Seo, Hee Ri Na, Na, Kuk Young, Yim, Hyun Ee, Kim, Tae Hee, Kang, Doo Kyoung, Oh, Ki Keun, Kang, Seok Yun, An, Young-Sil, Chun, Mison, Kim, Woojae, Park, Rae Woong, Jung, Yong Sik, Kim, Ku Sang
Format:	Journal Article
Language:	English
Published:	Korea (South) Korean Breast Cancer Society 01-03-2012 한국유방암학회
Subjects:	Original 일반외과학 Breast Granulomatous mastitis Tuberculous mastitis
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Summary:	Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of unknown etiology. The diagnosis of IGM requires that other granulomatous lesions in the breast be excluded. Tuberculous mastitis (TM) is also an uncommon disease that is often difficult to differentiate from IGM. The purpose of this study is to develop a new algorithm for the differential diagnosis and treatment of IGM and TM. Medical records of 68 patients (58 with IGM and 10 with TM) between July 1999 and February 2009 were retrospectively reviewed. The mean age of the patients was 33.5 (IGM) and 40 (TM) years (p=0.018). The median follow-up was 84 months. Of the total 10 patients with TM, 5 patients had a history of pulmonary tuberculosis. The most common symptoms of the diseases were breast lump and pain. However, axillary lymphadenopathy was more seen in TM (50%) compared to IGM (20.6%) (p=0.048). TM showed more cancer-mimicking findings on radiologic study (p=0.028). In IGM, 48 patients (82.7%) underwent surgical wide excision and 21 patients (36.2%) were managed with corticosteroid therapy and antibiotics. All of the TM patients received anti-tuberculosis medications and 9 patients (90%) underwent wide excision. The mean treatment duration was 2.8 months in IGM and 8.4 months in TM. Recurrence developed in 5 patients (8.6%) in IGM and 1 patient (10%) in TM. This study shows different characteristics between IGM and TM. The IGM patients were younger and had more mastalgia symptoms than the TM patients. Axillary lymphadenopathy was seen more often in TM patients. Half of the TM patients had pulmonary tuberculosis or tuberculosis lymphadenitis. Surgical wide excision might be both therapeutic and useful for providing an exact diagnosis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 G704-SER000010237.2012.15.1.010
ISSN:	1738-6756 2092-9900
DOI:	10.4048/jbc.2012.15.1.111