Idiopathic granulomatous lobular mastitis

ABSTRACT

To study the histologic and clinical features of idiopathic granulomatous lobular mastitis among Saudi females in Asir Region and to increase awareness of this disease among pathologists and surgeons practicing in the Kingdom of Saudi Arabia. A review of 312 breast biopsies at the histopathology laboratory of Asir Central Hospital, over an eight and a half year period [January 1987 to June 1995] revealed a total of 8 cases of granulomatous mastitis. Only one case proved to be tuberculous mastitis and is excluded from the current study. The remaining 7 cases fitted the diagnosis of idiopathic granulomatous lobular mastitis. The latter diagnosis was made based on the classic histological features and absence of microorganisms using special stains and cultures. The mean age of the 7 patients was 28.8 years [range 22-23 years]. Right and left sides of the breast were equally affected and all patients gave a history of delivery within 3 years before the biopsy was taken [mean no. of years since last delivery = 1.6 years; range =0.4-3 years]. Malignancy was clinically suspected in 4 patients, chronic inflammation was only suspected in one patient and no prebiopsy clinical impression was given for the two remaining cases. Treatment and follow-up of the 7 cases is not well documented as complete excision was carried out in 4 cases with lesion free follow-up period of only 1.5 years, whereas in the remaining 3 cases an incisional biopsy was carried out and patients were lost to follow-up. The current study showed that histological and clinical feature idiopathic granulomatous lobular mastitis among Saudi female patients is similar to that reported in other countries and that this disease is not uncommon in Saudi Arabia. Therefore, the awareness of this entity should be increased among pathologists and surgeons in Saudi Arabia