Clinical, microbiological, immunological and hormonal profiles of patients with granulomatous mastitis

Esmaeil,Nawzad K.; Salih,Abdulwahid M.; Hammood,Zuhair D.; Pshtiwan,Lana R.A.; Abdullah,Ari M.; Kakamad,Fahmi H.; Abdullah,Hiwa O.; Ahmed,Gasha S.; Abdalla,Berun A.; Salih,Rawezh Q.

doi:10.3892/br.2023.1624

Clinical, microbiological, immunological and hormonal profiles of patients with granulomatous mastitis

Authors:
- Nawzad K. Esmaeil
- Abdulwahid M. Salih
- Zuhair D. Hammood
- Lana R.A. Pshtiwan
- Ari M. Abdullah
- Fahmi H. Kakamad
- Hiwa O. Abdullah
- Gasha S. Ahmed
- Berun A. Abdalla
- Rawezh Q. Salih
View Affiliations

Affiliations: Department of Medical Laboratory Technology, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Kurdistan 46000, Iraq, Department of Scientific Affairs, Smart Health Tower, Sulaymaniyah, Kurdistan 46000, Iraq, Kscien Organization, Sulaymaniyah, Kurdistan 46000, Iraq
Published online on: May 18, 2023 https://doi.org/10.3892/br.2023.1624
Article Number: 41
Copyright: © Esmaeil et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Various studies on the etiology and other aspects of granulomatous mastitis (GM) have been performed; however, a lot of controversies have arisen. The present study aimed to present the clinicopathological findings and identify the sensitivity and resistance of isolated bacteria in patients with GM. In this cross‑sectional study 63 female patients with a confirmed histopathological diagnosis of GM were included. A core needle biopsy was conducted for the patients to obtain a sample for histopathological examination and bacterial culture. In total, 46 types of antibiotics were used to determine the sensitivity and resistance of each isolated bacterial species. All the medical and clinical records of the patients were acquired through the completion of a questionnaire form in person or, if necessary, through the evaluation of their medical records in the database of the relevant center. The majority of the patients were in the premenopausal or perimenopausal period. GM was unilateral in 58.7% of the patients. The most common symptom was pain, followed by fever and chills. The mean ranges of the erythrocyte sedimentation rate, C‑reactive protein, IL‑6, IL‑17, C5a, white blood count, neutrophil‑to‑lymphocyte ratio, and prolactin tests were significantly elevated in comparison to the normal ranges. In total, nine different bacterial species were isolated from the bacterial culture of the core biopsy samples, and 50% of the isolated bacterial species were sensitive to trimethoprim‑sulfamethoxazole. Since there is no consensus on the etiology of GM, any additional studies related to this aspect expand the current understanding of this puzzling condition.

View Figures

View References

1	Kessler E and Wolloch Y: Granulomatous mastitis: A lesion clinically simulating carcinoma. Am J Clin Pathol. 58:642–646. 1972.PubMed/NCBI View Article : Google Scholar
2	Barreto DS, Sedgwick EL, Nagi CS and Benveniste AP: Granulomatous mastitis: Etiology, imaging, pathology, treatment, and clinical findings. Breast Cancer Res Treat. 171:527–534. 2018.PubMed/NCBI View Article : Google Scholar
3	Bayrak BY, Cam I, Eruyar AT and Utkan NZ: Clinicopathological evaluation of idiopathic granulomatous mastitis patients: A retrospective analysis from a tertiary care hospital in Turkey. Ann Diagn Pathol. 55(151812)2021.PubMed/NCBI View Article : Google Scholar
4	Benson JR and Dumitru D: Idiopathic granulomatous mastitis: Presentation, investigation and management. Future Oncol. 12:1381–1394. 2016.PubMed/NCBI View Article : Google Scholar
5	Huang YM, Lo C, Cheng CF, Lu CH, Hsieh SC and Li KJ: Serum C-reactive protein and interleukin-6 levels as biomarkers for disease severity and clinical outcomes in patients with idiopathic granulomatous mastitis. J Clin Med. 10(2077)2021.PubMed/NCBI View Article : Google Scholar
6	Altintoprak F, Karakece E, Kivilcim T, Dikicier E, Cakmak G, Celebi F and Ciftci IH: Idiopathic granulomatous mastitis: An autoimmune disease? ScientificWorldJournal. 2013(148727)2013.PubMed/NCBI View Article : Google Scholar
7	Alsaleh N: Assertive clinical practice in managing patients with idiopathic granulomatous mastitis: Review of literature. Ann Med Surg (Lond). 70(102792)2021.PubMed/NCBI View Article : Google Scholar
8	Altieri M, Barra F, Casabona F, Soriero D, Gustavino C and Ferrero S: Idiopathic granulomatous mastitis: Etiopathogenetic considerations on a rare benign inflammatory breast disease. J Invest Surg. 34:998–999. 2021.PubMed/NCBI View Article : Google Scholar
9	Aghajanzadeh M, Hassanzadeh R, Alizadeh Sefat S, Alavi A, Hemmati H, Esmaeili Delshad MS, Emir Alavi C, Rimaz S, Geranmayeh S, Najafi Ashtiani M, et al: Granulomatous mastitis: Presentations, diagnosis, treatment and outcome in 206 patients from the north of Iran. Breast. 24:456–460. 2015.PubMed/NCBI View Article : Google Scholar
10	Esmaeil NK, Salih AM, Pshtiwan LRA, Muhialdeen AS, Abdullah AM, Hama JI, Hammood ZD, Kakamad FH, Tahir SH, Abdalla BA, et al: Management of idiopathic granulomatous mastitis: A single institution experience. Breast Care. 1–8. 2023.
11	Larsen LH, Peyvandi B, Klipfel N, Grant E and Iyengar G: Granulomatous lobular mastitis: Imaging, diagnosis, and treatment. AJR Am J Roentgenol. 193:574–581. 2009.PubMed/NCBI View Article : Google Scholar
12	Choi SH, Jang KS and Chung MS: Bilateral granulomatous mastitis with a different etiology. Cancer Biomarkers. 15:333–338. 2015.PubMed/NCBI View Article : Google Scholar
13	Yin Y, Liu X, Meng Q, Han X, Zhang H and Lv Y: Idiopathic granulomatous mastitis: Etiology, clinical manifestation, diagnosis and treatment. J Invest Surg. 35:709–720. 2022.PubMed/NCBI View Article : Google Scholar
14	Azizi A, Prasath V, Canner J, Gharib M, Sadat Fattahi A, Naser Forghani M, Sajjadi S, Farhadi E, Vasigh M, Kaviani A, et al: Idiopathic granulomatous mastitis: Management and predictors of recurrence in 474 patients. Breast J. 26:1358–1362. 2020.PubMed/NCBI View Article : Google Scholar
15	Kiyak G, Dumlu EG, Kilinc I, Tokaç M, Akbaba S, Gurer A, Ozkardes AB and Kilic M: Management of idiopathic granulomatous mastitis: Dilemmas in diagnosis and treatment. BMC Surg. 14(66)2014.PubMed/NCBI View Article : Google Scholar
16	Saydam M, Yilmaz KB, Sahin M, Yanik H, Akinci M, Yilmaz I, Balas S, Azili C and Gulcelik MA: New findings on autoimmune etiology of idiopathic granulomatous mastitis: Serum IL-17, IL-22 and IL-23 levels of patients. J Invest Surg. 34:993–997. 2021.PubMed/NCBI View Article : Google Scholar
17	Al-Khaffaf B, Knox F and Bundred NJ: Idiopathic granulomatous mastitis: A 25-year experience. J Am Coll Surg. 206:269–273. 2008.PubMed/NCBI View Article : Google Scholar
18	Velidedeoglu M, Kilic F, Mete B, Yemisen M, Celik V, Gazioglu E, Ferahman M, Ozaras R, Yilmaz MH and Aydogan F: Bilateral idiopathic granulomatous mastitis. Asian J Surg. 39:12–20. 2016.PubMed/NCBI View Article : Google Scholar
19	Pak H, Maghsoudi LH, Soltanian A and Jafarinia S: Evaluation of clinical manifestation and risk factors of idiopathic granulomatous mastitis. Int J of Surg Open. 35(100380)2021.
20	Gurleyik G, Aktekin A, Aker F, Karagulle H and Saglamc A: Medical and surgical treatment of idiopathic granulomatous lobular mastitis: A benign inflammatory disease mimicking invasive carcinoma. J Breast Cancer. 15:119–123. 2012.PubMed/NCBI View Article : Google Scholar
21	Yigitbasi MR, Guntas G, Atak T, Sonmez C, Yalman H and Uzun H: The role of interleukin-33 as an inflammatory marker in differential diagnosis of idiopathic granulomatous mastitis and breast cancer. J Invest Surg. 30:272–276. 2017.PubMed/NCBI View Article : Google Scholar
22	Erhan Y, Veral A, Kara E, Ozdemir N, Kapkac M, Ozdedeli E, Yilmaz R, Koyuncu A, Erhan Y and Ozbal O: A clinicopthologic study of a rare clinical entity mimicking breast carcinoma: Idiopathic granulomatous mastitis. Breast. 9:52–56. 2000.PubMed/NCBI View Article : Google Scholar
23	Boutet P, Sulon J, Closset R, Detilleux J, Beckers JF, Bureau F and Lekeux P: Prolactin-induced activation of nuclear factor kappaB in bovine mammary epithelial cells: Role in chronic mastitis. J Dairy Sci. 90:155–164. 2007.PubMed/NCBI View Article : Google Scholar
24	Cserni G and Szajki K: Granulomatous lobular mastitis following drug-induced galactorrhea and blunt trauma. Breast J. 5:398–403. 1999.PubMed/NCBI View Article : Google Scholar
25	Taylor GB, Paviour SD, Musaad S, Jones WO and Holland DJ: A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology. 35:109–119. 2003.PubMed/NCBI
26	Kıvılcım T, Altıntoprak F, Memiş B, Ferhatoğlu MF, Kartal A, Dikicier E, Ciftçi İH and Dilek FH: Role of bacteriological agents in idiopathic granulomatous mastitis: Real or not? Eur J Breast Health. 15:32–36. 2018.PubMed/NCBI View Article : Google Scholar
27	Williams MS, McClintock AH, Bourassa L and Laya MB: Treatment of granulomatous mastitis: Is there a role for antibiotics? Eur J Breast Health. 17:239–246. 2021.PubMed/NCBI View Article : Google Scholar