title: Granulomatous Lobular Mastitis.
abstract: BACKGROUND
  Granulomatous lobular mastitis (GLM) is a rare disorder that can clinically mimic breast carcinoma. The recommendation for diagnosis and treatment of GLM has not yet been established.
  
  
  OBJECTIVE
  To assess a series of GLM patients, including their clinical presentation, diagnosis, treatment and outcome.
  
  
  METHODS
  We retrospectively analyzed the clinical data and treatment of 17 female patients with biopsy-proven GLM. Breast tissue was obtained by a core needle biopsy (15 patients) or open biopsy (2 patients). Images were reviewed by an experienced radiologist.
  
  
  RESULTS
  The mean age of the patients at diagnosis was 44.6 ± 12.6 years. Five patients (29%) presented with bilateral disease, and seven (41%) presented with a mass, suggesting the initial diagnosis of breast carcinoma. Treatment comprised observation alone (23%), antibiotics (58.8%) and/or corticosteroids (with or without methotrexate) (35%). At the end of the study 70.6% of the patients demonstrated complete remission. None of the patients developed any systemic (granulomatous) disease or breast carcinoma during the follow-up period (4.7 ± 3.8 years).
  
  
  CONCLUSIONS
  Core needle biopsy is mandatory for the diagnosis of GLM and the exclusion of breast carcinoma. The recommended treatment modalities are observation alone or corticosteroids; surgery should be avoided. GLM is a benign disease with a high rate of resolution and complete remission.
authors.forename: Keren
authors.initials: K
authors.lastname: Mahlab-Guri
authors.forename: Ilan
authors.initials: I
authors.lastname: Asher
authors.forename: Tanir
authors.initials: T
authors.lastname: Allweis
authors.forename: Judith
authors.initials: J
authors.lastname: Diment
authors.forename: Zev M
authors.initials: ZM
authors.lastname: Sthoeger
authors.forename: Eliezer
authors.initials: E
authors.lastname: Mavor
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D062005:Biopsy, Large-Core Needle / Q000379:methods; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D058890:Granulomatous Mastitis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007557:Israel; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D057832:Watchful Waiting / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D008727:Methotrexate