Presentation and Outcome of Granulomatous Mastitis in A Tertiary-Level Hospital

Open Access

Abstract

Introduction: Granulomatous Mastitis (GM) is a rare chronic inflammatory breast disease that clinically mimics breast carcinoma, posing significant diagnostic and therapeutic challenges. There is no universally accepted treatment protocol, and management varies widely. To evaluate the clinical presentation and initial outcomes of Granulomatous Mastitis in patients attending a tertiary-level hospital. Methods & Materials: This descriptive observational study was conducted at the Department of Surgery, Comilla Medical College Hospital, from January to June 2019, involving 50 female patients aged 18-65 years diagnosed with GM by cytology or histopathology. Data were collected through face-to-face interviews, clinical examinations, and diagnostic investigations. Analysis was performed using SPSS version 23.0. Results: The mean age was 33.8±8.9 years, with most patients (38%) in the 21-30 years age group. Breast lump (52%) was the most common presentation, followed by breast abscess (44%). Core needle biopsy demonstrated superior diagnostic yield (91.7%) compared to FNAC (33.3%). Steroid therapy showed favorable initial response in 71.7% of patients, while antibiotic therapy alone was largely ineffective (4% success). Combination therapy with methotrexate and steroids achieved 71.4% success, and surgery for extensive refractory cases showed 100% success in a small subset. Conclusion: Giant Mastitis (GM) predominantly impacts women of reproductive age, often manifesting as breast lumps or abscesses. The preferred diagnostic approach is core needle biopsy, and corticosteroids are considered effective as initial treatment. The exclusive use of antibiotics should be discouraged. Long-term prospective studies with extended follow-up are required to accurately determine recurrence rates and to establish optimal treatment protocols.