Ultrasound classification-guided minimally invasive rotary cutting in granulomatous lobular mastitis

• Published in: BMC women's health Vol. 20; no. 1; p. 252
• Main Authors: Liao, Hongye, Guo, Jujiang, Chen, Xuming, Hua, Zhipeng, Lin, Juli, Weng, Yiyin
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16.11.2020; BioMed Central; BMC
• Subjects: Abscesses; Adult; Breast surgery; Catheters; Classification; Contraindications; Diagnosis; Disease; Esthetic outcomes; Female; Granulomatous lobular mastitis (GLM); Granulomatous Mastitis - diagnostic imaging; Granulomatous Mastitis - surgery; Humans; Hypertension; Inflammation; Laparoscopy; Mammography; Mammotome minimally invasive rotary cutting technology; Mastitis; Methods; Minimally Invasive Surgical Procedures; Patients; Psychosis; Retrospective Studies; Surgery; Treatment Outcome; Ulcers; Ultrasonic imaging; Ultrasonography classification; Ultrasonography, Interventional; Ultrasound imaging; Viral infections; Womens health; China; Esthetic outcomes; Mammotome minimally invasive rotary cutting technology; Ultrasonography classification; Granulomatous lobular mastitis (GLM)
• ISSN: 1472-6874; 1472-6874
• DOI: 10.1186/s12905-020-01118-y

To summarize the clinical experience of ultrasound-guided minimally invasive surgery for granulomatous lobular mastitis (GLM), and explore the feasibility of this technique for treating GLM. This retrospective study reviewed the clinical features and treatment outcome of 30 patients who were diagnosed pathologically as GLM from 2016.3 to 2019.5 in the Department of Breast Surgery, Women's and Children's Hospital, Xiamen University. These patients weretreated with ultrasound-guided Mammotome minimally invasive surgery, and we tried to classified the lesion into four distinct patterns (diffuse abscess mixed type, sheet hypoechoic type, localized abscess type, localized hypoechoic mass type) according to the sonographic findings and clinical symptoms to find out if these patterns correlated with treatment and recurrence rate. After a median follow-up of 12 months on average (4-42 months), 26 cases (86.7%) were cured without acute or chronic complications such as disseminated inflammation and bleeding. Post-operative bleeding occurred in 1 case, and 3 cases (10.00%) relapsed. The ultrasound classification had 0 cases of diffuse abscess mixed type, 17 cases (56.7%) of sheet hypoechoic type, 9 cases (30%) of localized abscess type, and 4 cases (13.3%) of localized hypoechoic mass type. All 3 recurrent cases were sheet hypoechoic type, which were cured after another open surgical resection and showed no recurrence during an average follow-up of 20 months (11-40 months). In treating GLM patients with minimally invasive rotary cutting, ultrasound classification helps to select suitable patients, especially those with localized abscess and localized hypoechoic mass types with low recurrence rate, which is one of the safe and effective treatment methods.