Abstract

TORREGROZA-DIAZGRANADOS, Eduardo; GOMEZ CRUZ, María Constanza; VIANA, Luis Fernando  and  FIGUEROA, Juan David. Chronic idiopathic lobular granulomatous mastitis: a current pathology. rev. colomb. cir. [online]. 2007, vol.22, n.2, pp.83-90. ISSN 2011-7582.

Background: Chronic idiopathic granulomatous mastitis (ICGM) is a benign disease of the breast, of inflammatory nature and unknown etiology. The main clinical features of this entity resemble those of mammary cancer. Given that the clinical and diagnostic imaging findings are not specific, the correct diagnosis falls in the histopathologic study. Objectives: To describe the main clinical manifestations, the results of the diagnostic studies, and the most important findings in the pathlogical study of ICGM. Materials and methods: Beginning in January 2004, the authors implemented the personal registry of benign breast tumors, nonlactational mastitis, and ductal inflammatory disease; 77 patients were registered until September 2006, with data including clinical information, diagnostic methods, and treatment modalities. In this group of 77 patients, 20 had the diagnosis of ICGM. A descriptive statistical analysis based on the following variables was carried out: 1. Age; 2. Clinical presentation; 3. Associated illnesses; 4. Diagnostic methods employed; 5. histopathologic findings; 6. Clinical course. Results: The diagnosis of ICGM was initially made in 30 patient, and the diagnosis was confirmed in 20, while in the other 10 a specific inflammatory cause was identified. The average age of this group patients was 36 years, the youngest being 22.The most frequent clinical presentation was an inflammatory mass in the breast, while the outstanding finding was the association of ICGM with contralateral breast cancer and infection with HIV, an association that has not been reported in the literature. Conclusion: The diagnosis of ICGN represents a formidable clinical challenge, by virtue of the ambiguous clinical manifestations and the fact that the entity tends to resolve spontaneously. Thus, it is possible that ICGM remains undiagnosed in a significant number of cases. The identification of the underlying cause of ICGM in more than one third of our patients indicates that the histopathologic study is the should be considered as the only certain diagnostic method.

Keywords : mastitis; chronic granulomatous mastitis; breast neoplasm.

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