Author/Authors :
Yaghan, Rami J. Department of Surgery - College of Medicine and Medical Sciences - Arabian Gulf University - Manama, Bahrain - Department of Surgery and Urology - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan , Ayoub, Nehad M. Department of Clinical Pharmacy - Faculty of Pharmacy - Jordan University of Science and Technology - Irbid, Jordan , Hamouri, Shadi Department of Surgery and Urology - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan , Al-Mohtaseb, Alia Department of Pathology and Microbiology - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan , Gharaibeh, Maha Department of Diagnostic Radiology and Nuclear Medicine - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan , Yaghan, Lamees Department of Surgery and Urology - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan , Al-Dari, Mahmoud Department of Surgery and Urology - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan , Al-Kaff, Hiba Department of Surgery and Urology - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan , Al Zoubi, Nabil A. Department of Surgery and Urology - Faculty of Medicine - Jordan University of Science and Technology - Irbid, Jordan
Abstract :
Background. Iidiopathic granulomatous mastitis (IGM) is stereotypically described as a mysterious entity that mimics breast
carcinoma imposing management challenges. In 2002, we established a multidisciplinary team to treat patients with IGM. is study
aimed to evaluate the role of this team in improving patient outcomes. Also, a review of literature is provided to highlight recent
disease trends. Patients and Methods. Pertinent data for 44 patients treated for IGM from 2002 to 2018 were analyzed and compared
to data prior to 2002. Results. Mean age at diagnosis was 37.9 years±6.4. e diagnosis of IGM was confirmed by True-cut biopsy
(TCB), Frozen section (FS), and surgical biopsy in 70.5%, 25%, and 4.5% of patients, respectively. FS was used to assess the resection
margins in three patients. Suspicion for malignancy was raised in one out of 39 ultrasound reports, and one out of 20 mammography
reports. Wide local excision was the main treatment modality (95.5%). 19 patients (43.2%) received corticosteroids. Prior to 2002,
IGM was only recognized aer surgical resection with a 71% initial false impression of carcinoma. Aer 2002, the initial false clinical
impression of carcinoma dropped to 29.5%. Recurrence rate was 31.82%. Younger age at diagnosis was significantly associated with
recurrence (χ
2
=5.598; = 0.018). Chi-square analysis showed no significant association between BMI and recurrence (χ
2
=0.776;
= 0.678). Conclusion. e establishment of a multidisciplinary team for IGM was associated with a reduced erroneous impression
of breast cancer, and a reduced false positive radiological diagnosis of breast carcinoma. FS was a useful confirmatory procedure.
Our series included the first case of a diffuse papular rash as a systemic manifestation of IGM. Recent literature indicates that IGM
is changing its face. IGM is being reported in all age groups, and even in males. e clinical manifestations have markedly expanded.
Diagnosis by TCB has replaced blind surgical excision. More data regarding predictors of recurrence is accumulating.
Keywords :
Establishing , Multidisciplinary Team , Granulomatous Mastitis , Improving Patient Outcomes , Disease Trends
