Original Article

Close to Half of the Granulomatous Mastitis may be Tuberculosis Mastitis

10.5152/cjms.2020.1405

  • Çiğdem Özdilekcan
  • Filiz Duyar Ağca
  • Tarkan Özdemir
  • Sultan Çiğdem Irkkan
  • Mustafa Hamidullah Türkkanı

Received Date: 10.10.2019 Accepted Date: 30.06.2020 Cyprus J Med Sci 2020;5(3):217-220

BACKGROUND/AIMS

Granulomatous mastitis (GM) is a chronic inflammatory benign disease that presents differential diagnostic difficulties as well as delays in diagnosis and treatment. The purpose of this study was to analyze the demographic and clinical findings of GM patients and describe the treatment outcomes after empirical antituberculosis treatment.

MATERIAL and METHODS

Forty-eight women with breast symptoms and a verified diagnosis of GM from the year 2014–2016 were evaluated. Of these patients, 20 of them who were nonresponders to the standard nonspecific treatment were included in the study. The study group consisted of these patients who were placed on antituberculosis treatment and followed-up to evaluate the treatment response.

RESULTS

The median age at time of diagnosis was 34 years (range, 21–52). Of the total, 19 (95%) women had unilateral and 1 (5%) had bilateral breast involvement. Median time from the initiation of symptoms to the hospital admission was 7 days (range, 1–364), and median time from admission to diagnosis was 4.5 months (range, 1–120). Among the patients, 75% of them were admitted to the hospital in the first 60 days and 75% were admitted to three different health care centers until the definitive diagnosis. In addition, 41.7% (20/48) of patients could not be treated with nonspecific antiobitics and steroids but were treated empirically with anti-TB drugs. These patients had a complete response to the empirical antituberculosis treatment regimen.

CONCLUSION

Our results showed that 41.7% of GM may actually be TB mastitis according to our empirical treatment success results. Suspicion of breast tuberculosis is essential among pathologically verified GM patients who are especially clinically nonresponders to other treatment, with prolonged symptoms and recurrence. Empirical antituberculosis treatment can be recommended in pathologically proven GM patients especially in high-incidence regions for tuberculosis.

Keywords: Granulomatous mastitis, extrapulmonary tuberculosis, antituberculosis drugs, empirical treatment