Mastitis granulomatosa: presentación clínica, imagenológica e histológica. Serie de casos

Describe the clinical, imaging and histological features in patients diagnosed with idiopathic granulomatous mastitis that were seen in the Mastology Departments of 2 university hospitals. A descriptive observational study was conducted on a case series of patients that attended breast clinics in Hospital de San Jose and Hospital Infantil Universitario de San Jose in Bogota from October 1, 2008 to September 30, 2012. The study included 45 patients with diagnosis of granulomatous mastitis, and provides a description of the clinical features, diagnostic images, and treatments given. The mean age was 39 years. There was a low association with smoking and the use of oral contraceptives. The most frequent imaging categorization was BIRADS 3. Initial management with antibiotics showed complications in 96%. Surgical management had a relapse rate of 20%. Complications, such as fistula and collections were managed with quadrantectomy and surgical drainage. Idiopathic granulomatous mastitis is a chronic disease, and its diagnosis is histopathological. It has a wide spectrum of clinical features, and can simulate malignant disease. There is no standard management protocol, and antibiotics, steroids, and immunomodulators have shown no evidence for their recommendation. Surgical treatment may be required.