背景:特发性肉芽肿性乳腺炎(IGM)导致明显的临床症状和乳房畸形。本研究旨在通过与手术切除的比较,评估微波消融(MWA)治疗IGM的临床可行性。
方法:从2016年6月至2020年12月,回顾性纳入了该医院收治的234例连续患者。所有纳入患者均经乳腺活检病理证实为IGM。根据治疗类型将这些患者分为MWA组(n=91)和手术组(n=143)。两组患者在干预前都接受口服泼尼松。临床缓解率,复发率,手术疼痛,并发症,比较两组患者的BREASTQ评分。
结果:MWA组共340个病灶,最终纳入手术组的201个病灶.完全缓解率存在显著差异(96.7%vs.86.7%,p=0.020),复发率(3.3%vs.13.3%,p=0.020),手术时间(48.7±14.6minvs.68.1±36.4min,p<0.001),在MWA组和手术组之间观察到术后疼痛(p<0.001)和术后BREASTQ评分(p<0.001)。
结论:微波消融治疗IGM是可行的,由于其高治愈率和低复发率。由于MWA的侵入性最小,并且可以充分保留乳腺的腺体和轮廓,患者对乳房的外观更满意。因此,对于需要手术的复杂患者,MWA是一种很好的替代疗法。
BACKGROUND: Idiopathic granulomatous mastitis (IGM) results in notable clinical symptoms and breast deformity. This study aimed to evaluate the clinical feasibility of microwave ablation (MWA) for the treatment of IGM through comparison with surgical excision.
METHODS: From June 2016 to December 2020, a total of 234 consecutive patients admitted to the hospital were retrospectively included in this study. IGM was pathologically confirmed via breast biopsy in all included patients. These patients were divided into the MWA group (n = 91) and surgical group (n = 143) based on the type of treatment. Patients in both groups received oral prednisone prior to intervention. The clinical remission rate, recurrence rate, operative pain, complications, and BREAST Q score were compared between the two groups.
RESULTS: There were 340 lesions in the MWA group, and 201 lesions in the surgical group were ultimately included. Significant differences in the complete remission rate (96.7% vs. 86.7%, p = 0.020), recurrence rate (3.3% vs. 13.3%, p = 0.020), operation time (48.7±14.6 min vs. 68.1±36.4 min, p < 0.001), postoperative pain (p < 0.001) and postoperative BREAST Q score (p < 0.001) were observed between the MWA and surgical groups.
CONCLUSIONS: Microwave ablation is feasible for the treatment of IGM, due to its high curative rate and low recurrence rate. Because of the minimal invasiveness of MWA and sufficient preservation of the gland and contour of the breast, patients are more satisfied with the appearance of the breast. Therefore, for patients with complex conditions requiring surgery, MWA is a good alternative treatment.