Idiopathic Granulomatous Mastitis (IGM) is an uncommon benign chronic inflammatory condition of the breast, occurring most commonly in women of childbearing age with a higher incidence in certain geographical areas. The aetiology is uncertain and diagnosis is difficult; it is usually made by exclusion. The clinical and radiological features often overlap with those of other benign diseases of the breast in women, but also with those of breast cancer, which is why early diagnosis is necessary to allow timely intervention when required. Its evolution is unpredictable and there is currently no consensus on the optimal treatment for these patients.The aim of this book is to provide readers with an overview of the data available to date on this unknown and controversial disease. General surgeons, breast surgeons, general practitioners, internal medicine specialists, pathologists, radiologists, rheumatologists, immunologists and dermatologists will certainly benefit from this practical guide.
Author(s): Hande Koksal, Naim Kadoglou
Publisher: Springer
Year: 2023
Language: English
Pages: 164
City: Cham
Foreword
Acknowledgement
Contents
Contributors
Overview on Idiopathic Granulomatous Mastitis
1 Introduction
2 Definition
3 Historical Perspective
References
Epidemiology
1 Gender
2 Age
3 History of Parity and Breastfeeding
4 Ethnicity
5 Place of Residence of the Patients
6 Education
7 Seasonal Fluctuation
References
Etiology and Pathogenesis
1 α1-Antitrypsin Deficiency
2 Oral Contraceptives
3 Hyperprolactinemia
4 Gestation, Birth, and Breastfeeding
5 Autoimmunity and Immune Dysregulation
References
The Role of Genetic Factors
1 Genetic Polymorphism Studies
2 Gene Expression Studies
3 Human Microbiome Studies
4 The Future
References
Clinical Manifestations and Classification
1 Local Manifestations
2 Extramammarian Manifestations
3 Classification
References
Microbiology and Biological Markers
1 Introduction
2 Pathophysiology and Pathogenesis
3 Infection and IGM
4 Antibiotic Treatment in IGM
5 Markers in Diagnosis and Investigations
5.1 C-Reactive Protein and Interleukin-6
5.2 Neutrophil-to-Lymphocyte Ratio (NLR) and IGM
5.3 sTREM-1 (Soluble Triggering Receptor Expressed on Myeloid Cells) and IGM
5.4 Interleukin-33 in IGM
6 Summary
References
Imaging Studies in Idiopathic Granulomatous Mastitis
1 Mammography
2 Ultrasonography
2.1 Doppler Ultrasonography
2.2 Sonoelastography
3 Interventional Procedures
4 Breast Magnetic Resonance Imaging
4.1 Diffusion Breast Magnetic Resonance Imaging
5 Positron Emission Tomography and Computed Tomography Scans (PET/CT)
References
Imaging Appearances and Differential Diagnosis of Idiopathic Granulomatous Mastitis
1 Introduction
2 Radiological Appearances
3 Mammography
4 Ultrasound
5 Magnetic Resonance Imaging
6 Computed Tomography
7 Other Conditions that Can Mimic IGM
7.1 Infective Mastitis
7.2 Periductal Mastitis
7.3 Tuberculous Mastitis
7.4 Sarcoidosis
7.5 Malignancy
7.6 Diabetic Mastopathy
7.7 Mastitis in Other Autoimmune Conditions
8 Conclusion
References
Pathology of Idiopathic Granulomatous Mastitis
1 Fine-Needle Aspiration Cytology
2 Gross Pathology
3 Histopathology
4 Ancillary Diagnostic Studies
References
Pathological Differential Diagnoses for Granulomatous Mastitis
1 Granulomatous Mastitis
2 Idiopathic Granulomatous Mastitis
3 Differential Diagnoses for Granulomatous Mastitis
3.1 Breast Infarct
3.1.1 Macroscopic Description
3.1.2 Microscopic Description
3.2 Xanthogranulomatous Mastitis (Fat Necrosis)
3.2.1 Macroscopic Description
3.2.2 Microscopic Description
3.3 Plasma Cell Mastitis
3.3.1 Macroscopic Description
3.3.2 Microscopic Description
3.4 Periductal Mastitis
3.4.1 Macroscopic Description
3.4.2 Microscopic Description
3.5 Cystic Neutrophilic Granulomatous Mastitis
3.5.1 Macroscopic Description
3.5.2 Microscopic Description
3.6 Sarcoidosis
3.6.1 Macroscopic Description
3.6.2 Microscopic Description
3.7 Mammary Tuberculosis
3.7.1 Macroscopic Description
3.7.2 Microscopic Description
3.8 Granulomatous Reaction in Carcinoma
3.8.1 Macroscopic Description
3.8.2 Microscopic Description
3.9 Inflammatory Pseudotumour/Inflammatory Myofibroblastic Tumor
3.9.1 Macroscopic Description
3.9.2 Microscopic Description
3.10 Wegener Granulomatosis in Breast
3.10.1 Macroscopic Description
3.10.2 Microscopic Description
3.11 Lupus Mastitis
3.11.1 Macroscopic Description
3.11.2 Microscopic Description
3.12 Paraffinoma (Sclerosing Lipogranuloma)
3.12.1 Macroscopic Description
3.12.2 Microscopic Description
3.13 Silicone Granuloma
3.13.1 Macroscopic Description
3.13.2 Microscopic Description
3.14 Eosinophilic Mastitis
3.14.1 Macroscopic Description
3.14.2 Microscopic Description
3.15 Diabetic Mastopathy
3.15.1 Macroscopic Description
3.15.2 Microscopic Description
3.16 Mammary Amyloidosis
3.16.1 Macroscopic Description
3.16.2 Microscopic Description
3.17 IgG4-Related Sclerosing Mastitis
3.17.1 Macroscopic Description
3.17.2 Microscopic Description
3.18 Histoplasmosis
3.18.1 Macroscopic Description
3.18.2 Microscopic Description
3.19 Blastomycosis
3.19.1 Macroscopic Description
3.19.2 Microscopic Description
3.20 Cryptococcosis
3.20.1 Macroscopic Description
3.20.2 Microscopic Description
3.21 Aspergillosis
3.21.1 Macroscopic Description
3.21.2 Microscopic Description
3.22 Coccidiodomycosis
3.22.1 Macroscopic Description
3.22.2 Microscopic Description
3.23 Filariasis
3.23.1 Macroscopic Description
3.23.2 Microscopic Description
References
Medical Treatment and Prognosis
1 Treatment Approaches
1.1 Conservative Approaches
1.1.1 Wait and Watch
1.1.2 Antibiotics Only
1.1.3 Nonsteroidal Anti-Inflammatory Drugs
1.1.4 Immunosuppressive Treatment
Corticosteroids
Systemic Corticosteroid Therapy
Local Corticosteroid Therapy
Topical Corticosteroid Therapy
Intralesional Corticosteroid Therapy
Methotrexate
Azathioprine
Mycophenolate Mofetil
1.1.5 Traditional Treatment
1.1.6 Others
Colchicine
Etanercept
Minocycline
Platelet-Rich Plasma
Conclusion
Treatment of IGM Patients with Erythema Nodosum
Treatment of IGM Patients with Pregnancy
2 Prognosis
References
Surgical Treatment
1 Surgical Procedures
1.1 Drainage
1.2 Excision
1.3 Breast-Conserving Surgery
1.4 Mastectomy
References
