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CC BY 4.0 · Rev Bras Ginecol Obstet 2023; 45(06): 319-324
DOI: 10.1055/s-0043-1770089
Original Article
Mastology

Treatment and Management Experience of Idiopathic Granulomatous Mastitis in a Low-income Country

Experiência de tratamento e manejo da mastite granulomatosa idiopática em um país de baixa renda
Pedro Antonio Llancari
1   Emergency Department, Instituto Nacional Materno Perinatal, Lima, Peru
2   School of Medicine “San Fernando.” Universidad Nacional Mayor de San Marcos, Lima, Peru
,
Antonio Ortiz 
3   Gynecology Oncology and Breast Unit, Department of Gynecology, Instituto Nacional Materno Perinatal, Lima, Peru
,
Juan Becerra 
1   Emergency Department, Instituto Nacional Materno Perinatal, Lima, Peru
,
Ricardo Muñoz 
3   Gynecology Oncology and Breast Unit, Department of Gynecology, Instituto Nacional Materno Perinatal, Lima, Peru
,
Christiam Valeriano 
3   Gynecology Oncology and Breast Unit, Department of Gynecology, Instituto Nacional Materno Perinatal, Lima, Peru
,
Rommy Helena Novoa 
4   High-Risk Pregnancy Unit, Department of Obstetrics and Perinatology, Instituto Nacional Materno Perinatal, Lima, Peru
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Abstract

Objective Reporting our experience of the management and treatment of Idiopathic granulomatous mastitis (IGM) in a low-income country by describing patients characteristics and therapy with emphasis on conservative surgical excision and postoperative care as the cornerstone of treatment.

Methods A retrospective cohort of women with histopathological diagnosis of IGM from 2014 to 2018 at Instituto Nacional Materno Perinatal in Lima, Peru. Patients' characteristics, clinical presentation, treatment, management, postoperative care, and follow-up were analyzed.

Results Thirty-eight patients with histopathological diagnosis of IGM were identified. Their average age was 35.9 years and 23 (60.5%) reported previous use of hormonal contraceptives. Nine (23.7%) patients had chronic mastitis with previous treatment. The time from the onset of symptoms to the first clinic consult was 5.1 months on average. Twenty-one (55.3%) patients had the lesion in the right breast, with a mean size of 6.9 cm. Conservative surgical excision was performed in all patients. Additionally, 86.8% required corticosteroids and 78.9% were treated with antibiotics. Complete remission was obtained at 141 days on average (range 44 to 292 days). Six (15.8%) women reported ipsilateral recurrence and 5 (13.2%), contralateral. The latency time was 25.5 months on average.

Conclusion The conservative surgical treatment demonstrated and close follow-up made for a high cure rate, but with recurrence similar to that reported in the literature. Use of gloves is an alternative to manage post operative wounds in a low-income country. The most frequent adverse effect was breast surgical scar.

Keywords

idiopathic granulomatous mastitis - breast - surgery - corticosteroid - recurrence

Contributions

All authors contributed to the design of the study and were involved in the data collection, data analysis and/or interpretation. Also, all authors contributed to manuscript writing/substantive editing and review and approved the final draft of the manuscript.




Publikationsverlauf

Eingereicht: 05. September 2022

Angenommen: 13. Februar 2023

Artikel online veröffentlicht:
21. Juli 2023

© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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