The Effect Of Preoperative Adjuvant Therapy On The Surgical Treatment Of Granulomatous Lobular Mastitis

BackgroundGranulomatous mastitis is a chronic inflammation with pathological features of breast Granuloma of unknown etiology.granulomatous inflammation with lobular, it is called granulomatous lobular mastitis (Granulomatous lobular mastitis, GLM), It was first reported by Kessler in1972, has been found to be named as idiopathic granulomatous mastitis, breast granuloma or granulomatous lobular inflammation while going through literature, refers to the mammary gland of non-caseous necrosis confined to lobular granulomatous lesions. The etiology of granulomatous lobular mastitis remains unclear,and the optimal treatment of granulomatous mastitis is still a question worldwide as well. There is no sufficient data and evidence about the effect of antibiological therapy use on granulomatous mastitis. There is fairly high incidence of complications, such as abscess formation, fistulae, and chronic suppuration, the treatment of which require a through search for organisms in the initial specimen. Mixed aerobic and anaerobic infections may be seen and antibiotics should be used. If no organisms are detected, steroid therapy has been found to be useful in some of these persistent cases. Granulomatous mastitis treatment is complicated and needs patience and long-term follow-up.In this study,we pay attention to the effect of the preoperative adjuvant therapy on the surgery treatment of granulomatous lobular mastitis and probe into the mechanism of preoperative adjuvant therapy. ObjectiveTo explore the effect of the preoperative adjuvant therapy on efficacy of the surgical treatment of granulomatous lobular mastitis and the mechanism of the preoperative adjuvant therapy.MethodsGo through medical records concerned and make a retrospective analysis of60patients’therapy.They received treatment in Breast Surgery Department of the First Affiliated Hospital of Zhengzhou University from September2005to September2011.They were chosen to be the objects of the study, and their postoperative pathological diagnosis were granulomatous lobular mastitis.30cases were given preoperative adjuvant therapy,while30cases received operation directly.We observed the tumor size which was measured by Color Doppler ultrasound before operation and wound healing after operation conducted by the experienced surgeon of breast surgery.We did follow-up of the60patients,and observed the recurrence rate of them.Result30patients received the preoperative adjuvant therapy before operation,21patients’tumor size reduced while9patients’tumor size didn’t change before operation,28patients’wound healing were good while2patients’wound were poor healing.30patients received operation directly,of which10patients’tumor size reduced while20stayed the same before operation,20patients’wound healing were good while10poor healing. During the follow-up period,4patients given preoperative adjuvant therapy relapsed one or more than one time, and the recurrence rate was14.3%,2cases lost follow-up;9patients given operation directly relapsed one or more than one time, and the recurrence rate was33.3%,3cases lost follow-up. ConclusionThe preoperative adjuvant therapy can reduce the tumor size and improve the wound healing of patients of granulomatous lobular mastitis after operation.There is no significant difference between them in reducing recurrence rate of granulomatous lobular mastitis.