Delayed breast reconstruction in idiopathic granulomatous mastitis

Abstract

Background

Idiopathic granulomatous mastitis is an exceptionally rare, chronic benign inflammatory disease of the breast, more common in developing countries and infrequently seen bilaterally. The symptoms can mimic many other breast conditions, including inflammatory breast carcinoma, and the diagnosis is one of exclusion. The management includes non-surgical treatments, such as broad spectrum antibiotics, steroids and methotrexate, and surgical options, comprising of wide local excision and even simple mastectomy.

Methods

The case notes of patients with idiopathic granulomatous mastitis referred to our Breast Unit were reviewed and data was collected on patients demographics, medical and surgical treatments and subsequent outcomes.

Results

Four patients were treated in our unit, all Caucasian women, three of whom were bilateral cases. Three of the patients were reconstructed using oncoplastic techniques whilst the fourth patient awaits reonstruction.

Conclusions

Oncoplastic breast reconstructive techniques play a fundamental role in the management of these patients, as they give the surgeon the freedom to perform a wider resection, thus reducing the rate of recurrence, whilst at the same time, knowing that there are reconstructive options to restore any breast aesthetics. As such, the value of a multidisciplinary team cannot be underestimated.

Level of Evidence: Level V, therapeutic study.

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