ObjectiveTo compare curative effect of catheter drainage following ultrasound-guided vacuum-assisted rotary excision and traditional excision in treatment of granulomatous mastitis in abscess stage. MethodsA total of 38 patients with granulomatous mastitis in abscess phase from December 2016 to March 2017 in the Third People’s Hospital of Chengdu City and from March 2017 to October 2017 in the Sichuan Provincial Hospital for Women and Children were included as a study group, who were received the catheter drainage following ultrasound-guided vacuum-assisted rotary excision. A total of 38 similar cases from July 2015 to November 2016 in the Third People’s Hospital of Chengdu City were collected as a control group according to the 1∶1 matching principle, who were received the traditional excision. The therapeutic period, postoperative appearance of breast, and recurrence rate were compared between these two groups. ResultsCompared with the control group, the therapeutic period was significantly shorter (t=74.000, P<0.001), the postoperative appearance of breast was significantly better (χ2=7.280, P=0.007) in the study group, while the recurrence rate had no significant difference (χ2=0.559, P=0.455) between these two groups. ConclusionsCatheter drainage following ultrasound-guided vacuum-assisted rotary excision shows advantages in postoperative therapeutic period and appearance of breast and doesn’t increase relapse rate as compared with traditional surgery for patients with granulomatous mastitis in abscess stage.
ObjectiveTo analyze therapeutic effect of ultrasound-guided vacuum-assisted rotary excision with tube irrigation drainage in treatment of granulomatous mastitis (GM).MethodsThe clinical data of 120 patients with GM from January 2018 to December 2018 in the Renmin Hospital of Wuhan University were analyzed. Sixty patients were treated with the ultrasound-guided vacuum-assisted rotary excision with tube irrigation drainage (control group), and the other 60 patients were treated with the metronidazole solution combined with dexamethasone on the basis of the control group (observation group). The therapeutic period, total effective rate, postoperative appearance of breast, and recurrence rate were analyzed. While the pathogenic bacteria was analyzed by the microbial culture and the pathogen gene detection.ResultsThere were no significant differences in the baseline data between the two groups (P>0.05). The ultrasound-guided vacuum-assisted rotary excisions were successfully performed in all 120 patients. The therapeutic period of the observation group was shorter than that of the control group (t=–3.633, P<0.001). The total effective rate and rate of excellent and good of postoperative breast appearance had no significant differences between the two groups (total effective rate: 96.7% versus 90.0%, χ2=1.922, P=0.166; rate of excellent and good of postoperative breast appearance: 96.7% versus 88.3%, χ2=1.205, P=0.272). The recurrence rate of the observation group was lower than that of the control group (χ2=5.175, P=0.023). The positive rates of bacteria were 25.8% and 58.8% in the 120 cases by the microbial culture and 52 cases by the pathogen gene detection, respectively, which had a statistical difference (χ2=16.974, P<0.001), the same conclusions were obtained in the observation group and the control group (χ2=6.691, P=0.010; χ2=9.379, P=0.002).ConclusionsUltrasound-guided vacuum-assisted rotary excision with tube irrigation drainage is well applied in treatment of GM. It could maintain a good shape of breast. Use of metronidazole solution combined with dexamethasone after surgery could shorten therapeutic period and reduce recurrence rate.
Granulomatous lobular mastitis (GLM) is a rare mastitis disease, which mainly occurs in childbearing period. The etiology, diagnosis and treatment of GLM are still disputed. In recent years, the role of Corynebacterium infection in the pathogenesis of GLM has attracted more and more attention. Cystic neutrophilic granulomatous mastitis (CNGM) has been proposed, and more and more studies have targeted CNGM as a unique subtype of GLM. This article summarizes the published literature on CNGM so far to discuss the research progress in clinicopathological features, microbiological findings, clinical diagnosis and treatment of CNGM.
ObjectiveTo construct a prediction model for the postoperative recurrence risk of granulomatous lobular mastitis (GM) based on multiple systemic inflammatory indicators and clinicopathologic characteristics, with the aim of guiding clinical treatment. MethodsThe GM patients who underwent lesion resection at Sichuan Provincial Hospital for Women and Children from January 2017 to March 2024 were retrospectively collected. The univariate and multivariate logistic regression analyses were used to screen the risk factors for recurrence after GM lesion resection, and a nomogram prediction model was constructed based on the risk factors. The test level was set at α=0.05. ResultsA total of 533 patients with GM were included in this study, of whom 118 cases (22.1%) developed postoperative recurrence. The results of multivariate analysis showed that the not taking oral bromocriptine, having microabscess formation in postoperative pathological examination, systemic immune inflammation index (SII) >789.0×109/L, and immunoglobulin E (IgE) >64.4 U/mL were the independent risk factors for recurrence after GM lesion resection. Based on the risk factors, the nomogram predicting recurrence risk was constructed. The area under the receiver operating characteristic curve (95%CI) was 0.913 (0.895, 0.932), and its sensitivity and specificity were 90.5% and 88.9%, respectively. The calibration curve showed that the probability of recurrence after GM lesion resection predicted by using the nomogram was highly consistent with the actual recurrence probability. The decision curve analysis showed that the nomogram had a good clinical net benefit. ConclusionsThe findings of this study suggest that close postoperative monitoring for recurrence is warranted in patients who did not receive oral bromocriptine treatment, presented with microabscess formation on pathological examination, and exhibited elevated SII and IgE level. The postoperative GM recurrence prediction nomogram model constructed based on risk factors demonstrates a good predictive performance, providing a valuable reference for early treatment and management strategies of GM.