granulomatous mastitis

[tanya34]

does granulomatous mastitis ever resolve on its own?  If not, what are the latest treatment options?


This discussion is related to Idiopathic granulomatous mastitis.

[zouzi]

Hi there,

      I would have loved to help you if I knew more about Granulomatous mastitis.The only suggestion I could make is that you post again on your own.When you add your question on other posts,members think is another comment and rarely respond,not knowing that it's actually a question from a new poster.To post your own question just click "Post a Question" at the top of the page. This way you will surely get a quick response.

[kanema]

I developed a breast lump two months ago, immediately contacted by OB/GYN who sent me for a Fine Needle Aspiration.  They did the test with no definative results.  They then performed a mamogram (which I have never had before - i am 34 years old), they stated it was "disturbing."  Then another FNA was performed with ultrasound guidance, again the results were not definitive.  The pathologist report diagnosed Granulomatous Mastisis. I was referred to a breast surgeon for an excisional biopsy to rule out an underlying tumor.  I had to wait more than a month to see the surgeon and am scheduled to have the biopsy in a few days.  I am scared to death that this may be cancer, I haven't had a good nights sleep in two months.  Can anyone give me some insight on this?  Not too much information out there.

[Miriamkh]

Hi,

I have IGM and developed joint pain in my wrists, hip, and ankles. My ankles became black and blue. There IS an association- it is called erythema nodustrum. The infectious disease specialist who diagnosed me with IGM was able to identify the erythema right away. The prednisone he put me on made the pain go away immediately.

[johnm02]

my wife has been diagnosed with granulommatous mastitis last week. she has now developed joint pain with stiffness- wrist and ankles. we have been told to start steroids for the mastitis but was told there is no association between the 2 problems. anyboby with similar complaints. please help.

[Tenderbreast]

I was diagnosed with IGM in late January 2008. Symptoms started in Dec. 2007, and it was first mistaken for breast cancer.  Since this is so rare, there is not a lot of info out there. I have spent time reading some of the medical studies available on the Internet - they are usually case studies of small groups of women. From that small sample, I learned that it does resolve itself sometimes without treatment.  But, the studies don't have insight into why that is the case.  And, of course, they are very small samples so it would be hard to generalize.  Based on what I saw, it seemed a bit rare for it to go away without any treatment.
I have been treated with prednisone and methotrexate. I started with prednisone and it worked wonders, but  the side effects were very bad.  (Dosages up to 40 mg a day, for extended periods).  When we started tapering the prednisone, the IMG came back, so we started the methotrexate.  I am now almost off of the prednisone, but am still on the methotrexate. The dr. just increased the dosage to 25 mg once a week. This drug, of course, can cause liver damage, etc..., so I have to get my blood checked every few months.   In any event, my hope is that I will not have to be on these drugs long term and that once the IGM goes away, I can taper the methotrexate.  
I would suggest looking at alternatives to surgery.  The primary specialist I see right now is a rheumatologist, as IGM is sometimes classified as an automimmune disorder.

[morethan1]

In my experience, no.  But there are very few cases of IGM and every patient is different.  There was a post in another discussion thread about nearly 100% success rate with double mastectomy.  I apparently am the exception.  Had a double mastectomy in September with reconstruction using the abdominal muscle.  Post operatively I noticed a lump that was harder than the rest and the surgeon said it would soften over time as the muscle atrophied.  Unfortunately, it started to get bigger and the skin became pink and peau d' orange in texture above the lump.  Now the skin is changing all over the "flap" and I have another surgery scheduled to remove the mass.  My breast surgeon is out on maternity leave and I was told that I would never need another breast surgeon since I don't have breast tissue anymore.  Not sure where to go to test the lump for IGM and not sure whether it can spread to the abdominal muscle and the rest of my body.  I don't think anyone knows the answer to that question.  Only about 1% of women get this and very few case studies apply to me.  My youngest is 15 so haven't breast fed in this millenium and still wound up with this disease.  

I would not recommend conservative treatment.  An infection like this can make your whole body sick.  Maybe I should have waited for the reconstruction to make sure it was gone before putting new tissue at risk.  Hindsight!  But then, who'd have thought it would come back after that aggressive treatment.  I would be very curious to know if anyone has ever heard of this before!

[glo3]

I have just been diagnosed with granulomatous mastitis. It was originally mistaken for a breast cancer until I had a core biopsy.
I have an abscess now which does not clear completely.
My doctor has advised expectant management for the time being so I am having no treatment at the moment. I will see him again in 10 days. I am very worried about taking steroids and I intend to look into chinese medicine, at least to relieve symptoms.
I would like to know the answer to your question, if GM ever resolves on its own.
Thanks

[japdip]

I can't really be more specific regarding the antibiotics over the internet; your Dr. would be the one to ask about the recommended medication. Surgery is not usually incorporated as part of the treatment unless it is to drain the abscess. If there is some suspicion of breast cancer on mammogram/ultrasound or MRI then the area is surgically removed  for biopsy along with the abscess.  I don't believe that letting the abscesses resolve on their own without  treatment is a good idea. If you haven't seen a Dr. about this then you should; if you have then I suggest that you get a second opinion.    Regards ....

[tanya34]

Thankyou so much for your comments.  
Could I ask what antibiotics and for how long would you recommend them to be taken.  
Also, at what point would someone opt for surgery?
I have had granulomatous mastitis for around 5 months with abscesses that have discharged spontaneously and resolved.  However the underlying lump appears to be growing all the time.

[japdip]

Antibiotics are the first line treatment for Granulomatous Mastitis. If not treated an abscess may form. It is important to keep nursing because if you stop then the chances of abscess formation increase. Regards .....