Granulomatous Mastitis

This disease, first described in 1972, is characterized by recurrent and persistent inflammation of the breast. Since it is the result of the body’s reaction to its own tissues, the Turkish name “Breast Rheumatism” makes it more understandable.

The appearance of the disease generally coincides with the middle of the childbearing age (30-35 years) in women of childbearing age (20-45 years).
It usually occurs in one breast, but less frequently in the other breast.
Most patients have an abscess, but it is usually not possible to drain it
The breast is usually red and tender with one or more punctures if the abscess has drained spontaneously.
In some patients, there is only a tender mass and symptoms such as redness and abscess may not develop at all.
Most of the time, patients are initially treated with antibiotics, but they either do not benefit or relapse, even if there is little regression.
Very rarely, tuberculosis (tuberculosis) is confused with breast inflammation and for this reason, a tuberculosis test is definitely performed before treatment.
Diagnosis is important because it can be confused with breast cancer.
Although imaging methods such as ultrasound-MR give an idea, the disease is diagnosed by needle biopsy.
After the diagnosis is made by needle biopsy, the first option for treatment is cortisol.
In our long-term studies, cream treatment is used as the first option, and oral treatment comes to the fore in patients with insufficient efficacy.
The frequency of recurrence after treatment is high (1 in every 5 patients), but cortisol treatment with cream-pill options is still the first option in recurrent patients.
In case of stubborn disease, immunosuppressive therapies are the next step.
Surgery is the option that should be used in patients with very limited disease or in patients who do not respond to any drug treatment.
In a patient with granulomatous mastitis, the amount of tissue removed by surgery is close to the entire breast, so serious consideration should be given before deciding on surgery.
In stubborn cases, in patients who prefer surgery, the option of completely evacuating the breast and reconstructing it with a prosthesis usually gives better results.
Experience comes to the forefront in the treatment of the disease and since it requires long-term follow-up, it is generally appropriate to be followed up by doctors who have intensively applied such treatments.
With the experience I have gained after the treatment and follow-up of around 300 patients, I would like to say that the disease is not incurable, especially with the correct use of treatment options, it is possible to get rid of the disease in all patients.