특발성 육아종성 유방염의 임상병리학적 특징, 경과 및 치료 결과

최서희; 박형석; 류제규; 김지예; 김상화; 박세호; 김승일

doi:http://dx.doi.org/10.14449/jbd.2015.3.1

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자료유형: 학술저널

저자정보: 최서희 (연세대학교 의과대학 외과학교실) 박형석 (연세대학교 의과대학 외과학교실) 류제규 (연세대학교 의과대학 외과학교실) 김지예 (연세대학교 의과대학 외과학교실) 김상화 (연세대학교 의과대학 외과학교실) 박세호 (연세대학교 의과대학 외과학교실) 김승일 (연세대학교 의과대학 외과학교실)

저널정보: 한국유방암학회 Journal of Breast Disease Journal of Breast Disease 제3권 제1호

발행연도: 2015.6

수록면: 1 - 7 (7page)

DOI: http://dx.doi.org/10.14449/jbd.2015.3.1

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Purpose: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory breast disease that mimics breast cancer in terms of clinical and radiological finding. The treatment of IGM remains controversial. We aim to evaluate the clinicopathological feature and outcomes of IGM. Methods: Fifty five pathologically confirmed IGM patients who were treated between 2005 and 2013 were enrolled. All patients were categorized into three groups according to treatment methods: conservative care including observation, aspiration, and antibiotics; steroid; surgical intervention groups. Results: The median age at time of diagnosis was 35.8 years (range, 20?49 years). The most common chief complaints were a palpable mass (40.0%) followed by painful mass (32.7%) and pain (21.8%). Thirty-one patients were treated with antibiotics for their initial treatment. Steroid treatment was initially performed in eighteen cases. The initial steroid treatment was changed to methotrexate treatment in six patients who developed side effects, such as steroid-induced diabetes mellitus and Cushing’s syndrome or showed no response to treatment. Surgical interventions were performed in six patients as the first-line treatment. Mean time to remission was 7.2±6.9 months and 1-year recurrence-free interval was 89%. Mean time to remission in conservative care group and steroid group was 5.3±5.6 months and 11.4±7.9 months, respectively, and it was significantly different (p=0.008). Conclusion: A multidisciplinary approach including close observation, antibiotics treatment, systemic steroid, methotrexate, and surgical intervention is the currently available treatment option for IGM. IGM should be closely followed up due to the frequency of disease recurrence.

#Breast #Breast diseases #Granulomatous mastitis #Steroids

참고문헌 (30)

참고문헌 신청

Al-Khaffaf B / 2008 / Idiopathic granulomatous mastitis:a 25-year experience / J Am Coll Surg 206:269~273

Lee SD / 2000 / Diagnosis and treatment of granulomatous mastitis / J Korean Surg Soc 58:487~493

Akbulut S / 2011 / Is methotrexate an acceptable treatment in the management of idiopathic granulomatous mastitis? / Arch Gynecol Obstet 284:1189~1195

Akbulut S / 2011 / Methotrexate in the management of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases / Breast J 17:661~668

Osborne BM / 1989 / Granulomatous mastitis caused by histoplasma and mimicking inflammatory breast carcinoma / Hum Pathol 20:47~52

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