Abstract：
OBJECTIVE: Idiopathic granulomatous mastitis (IGM) is a rare, benign, inflammatory breast disorder of unknown aetiology usually affecting women of reproductive age. It classically presents as a unilateral painful breast mass. It is frequently mistaken for carcinoma or other inflammatory breast diseases. Diagnostic investigations include clinical examination, appropriate imaging and tissue sampling. A link between IGM and infection with the Corynebacterium species in particular Corynebacterium kroppenstedtii has been described.
METHODS: A retrospective single-centre cohort study was conducted over a 5-year period (2017-2022); all cases of IGM were identified.
RESULTS: Forty-one patients were diagnosed with IGM. Breast lump was the most common presenting complaint (n=29). The average age was 45 years. Eighteen patients had samples sent for culture and sensitivity, 11 of which had positive microbiology results indicative of Corynebacterium spp infection.An 82% resolution rate (27 of 33) was recorded in those who received either a short-antibiotic course or none at all. Eight patients reported persistent disease at 3 months, five of which had evidence of Corynebacterium spp.
CONCLUSIONS: This 5-year review highlights the impact of IGM in a tertiary centre in Dublin, Ireland. Although no treatment guidelines exist, options include antibiotics, immunomodulators and surgery. Due to risk of fistulae and unfavourable cosmetic outcomes, surgery should be reserved for refractory IGM. We suspect that there may be a subset of patients where prolonged antibiotic therapy should be considered. Defining this subgroup requires further study, but likely includes those with cystic neutrophilic granulomatous mastitis, relapsing disease and in whom Corynebacterium spp is recovered.
METHODS: A retrospective single-centre cohort study was conducted over a 5-year period (2017-2022); all cases of IGM were identified.
RESULTS: Forty-one patients were diagnosed with IGM. Breast lump was the most common presenting complaint (n=29). The average age was 45 years. Eighteen patients had samples sent for culture and sensitivity, 11 of which had positive microbiology results indicative of Corynebacterium spp infection.An 82% resolution rate (27 of 33) was recorded in those who received either a short-antibiotic course or none at all. Eight patients reported persistent disease at 3 months, five of which had evidence of Corynebacterium spp.
CONCLUSIONS: This 5-year review highlights the impact of IGM in a tertiary centre in Dublin, Ireland. Although no treatment guidelines exist, options include antibiotics, immunomodulators and surgery. Due to risk of fistulae and unfavourable cosmetic outcomes, surgery should be reserved for refractory IGM. We suspect that there may be a subset of patients where prolonged antibiotic therapy should be considered. Defining this subgroup requires further study, but likely includes those with cystic neutrophilic granulomatous mastitis, relapsing disease and in whom Corynebacterium spp is recovered.
摘要：
目的：特发性肉芽肿性乳腺炎（IGM）是一种罕见的，良性,病因不明的炎性乳房疾病通常影响育龄妇女。它通常表现为单侧疼痛的乳房肿块。它经常被误认为是癌或其他炎性乳腺疾病。诊断性调查包括临床检查，适当的成像和组织采样。已经描述了IGM与棒状杆菌物种，特别是克氏棒状杆菌感染之间的联系。
方法：在5年期间（2017-2022年）进行了回顾性单中心队列研究；确定了所有IGM病例。
结果：41例患者被诊断为IGM。乳腺肿块是最常见的主诉（n=29）。平均年龄为45岁。18名患者有样本送去培养和敏感性，其中11具有阳性的微生物学结果，表明棒状杆菌属感染。在接受短期抗生素疗程或根本没有抗生素疗程的患者中，有82％的解决率（33个中的27个）。八名患者在3个月时报告了持续的疾病，其中五个有棒杆菌属的证据。
结论：这项为期5年的审查强调了IGM在都柏林三级中心的影响，爱尔兰。虽然没有治疗指南，选择包括抗生素，免疫调节剂和手术。由于瘘的风险和不利的美容结果，手术应保留用于难治性IGM。我们怀疑可能有一部分患者应该考虑延长抗生素治疗。定义这个子组需要进一步研究，但可能包括囊性中性粒细胞性肉芽肿性乳腺炎，复发性疾病，并在其中恢复了棒状杆菌属。
方法：在5年期间（2017-2022年）进行了回顾性单中心队列研究；确定了所有IGM病例。
结果：41例患者被诊断为IGM。乳腺肿块是最常见的主诉（n=29）。平均年龄为45岁。18名患者有样本送去培养和敏感性，其中11具有阳性的微生物学结果，表明棒状杆菌属感染。在接受短期抗生素疗程或根本没有抗生素疗程的患者中，有82％的解决率（33个中的27个）。八名患者在3个月时报告了持续的疾病，其中五个有棒杆菌属的证据。
结论：这项为期5年的审查强调了IGM在都柏林三级中心的影响，爱尔兰。虽然没有治疗指南，选择包括抗生素，免疫调节剂和手术。由于瘘的风险和不利的美容结果，手术应保留用于难治性IGM。我们怀疑可能有一部分患者应该考虑延长抗生素治疗。定义这个子组需要进一步研究，但可能包括囊性中性粒细胞性肉芽肿性乳腺炎，复发性疾病，并在其中恢复了棒状杆菌属。
