Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition)

• Published in: 军事医学研究（英文版） Vol. 9; no. 4; pp. 389 - 403
• Main Authors: Qian?Qian Yuan, Shu?Yuan Xiao, Omar Farouk, Yu?Tang Du, Fereshte Sheybani, Qing Ting Tan, Sami Akbulut, Kenan Cetin, Afsaneh Alikhassi, Rami Jalal Yaghan, Irmak Durur?Subasi, Fatih Altintoprak, Tae Ik Eom, Fatih Alper, Mustafa Hasbahceci, David Martínez?Ramos, Pelin Seher Oztekin, Ava Kwong, Cedric W.Pluguez?Turull, Kirstyn E.Brownson, Shirish Chandanwale, Mehran Habibi, Liu?Yi Lan, Rui Zhou, Xian?Tao Zeng, Jiao Bai, Jun?Wen Bai, Qiong?Rong Chen, Xing Chen, Xiao?Ming Zha, Wen?Jie Dai, Zhi?Jun Dai, Qin?Yu Feng, Qing?Jun Gao, Run?Fang Gao, Bao?San Han, Jin?Xuan Hou, Wei Hou, Hai?Ying Liao, Hong Luo, Zheng?Ren Liu, Jing?Hua Lu, Bin Luo, Xiao?Peng Ma, Jun Qian, Jian?Yong Qin, Wei Wei, Gang Wei, Li?Ying Xu, Hui?Chao Xue, Hua?Wei Yang, Wei?Ge Yang, Chao?Jie Zhang, Fan Zhang, Guan?Xin Zhang, Shao?Kun Zhang, Shu?Qun Zhang, Ye?Qiang Zhang, Yue?Peng Zhang, Sheng?Chu Zhang, Dai?Wei Zhao, Xiang?Min Zheng, Le?Wei Zheng, Gao?Ran Xu, Wen?Bo Zhou, Gao?Song Wu
• Format: Journal Article
• Language: English
• Published: Department of Thyroid and Breast Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,China%Department of Pathology,University of Chicago Pritzker School of Medicine,Chicago,IL 60637,USA%Department of Surgical Oncology and Breast Surgery,Oncology Center,Faculty of Medicine,Mansoura University,Mansoura 35516,Egypt%Department of Breast Surgery,Beijing University of Chinese Medicine,Beijing 100700,China%Department of Infectious Diseases and Tropical Medicine,Faculty of Medicine,Mashhad University of Medical Sciences,Mashhad 9177899191,Iran%Breast Department,KK Women's and Children's Hospital,100 Bukit Timah Road,Singapore 229899,Singapore%Department of Surgery,Department of Public Health,Department of Biostatistics,Bioinformatics and Medical Informatics,Inonu University Faculty of Medicine,44280 Malatya,Turkey%Department of General Surgery,Faculty of Medicine,?anakkale Onsekiz Mart University,17020?anakkale,Turkey%Department of Radiology,Cancer Institute,Imam Khomeini Hospital,Tehran University of Medical Sciences,Tehran 1419733141,Iran%Department of Surgery,College of Medicine and Medical Sciences,Arabian Gulf University?Bahrain,Manama 26671,Bahrain%Department of Radiology,International Faculty of Medicine,Istanbul Medipol University,34810 Istanbul,Turkey%Department of General Surgery,Faculty of Medicine,Sakarya University,54050 Sakarya,Turkey%Department of Surgery,HiU Clinic,170,Gwongwang?ro,Paldal?gu,Suwon 16488,Korea%Department of Radiology,Faculty of Medicine,Ataturk University,25240 Erzurum,Turkey%Academic Support and Education Center,H?rkai Serif District,Kececi Cesmesi Str,Doktorlar Building,B/7,34091 Istanbul,Turkey%Department of General and Digestive Surgery,Hospital General Castellon,Avda Benicassim S/N,12812004 Castellón,Spain%Radiology Department,Ankara Training and Research Hospital,305018 Ankara,Turkey%Department of Surgery,the University of Hong Kong,China,The University of Hong Kong?Shenzhen Hospital,Shenzhen 518053,China%University of Miami Health System and Miller School of Medicine,1475 NW 12th Avenue,Miami,FL 33136,USA%Department of Surgery,University of Utah,Huntsman Cancer Institute,Salt Lake City,UT 84112,USA%Department of Pathology,Dr D Y Patil Medical College Hospital and Research Centre,Pimpri,Pune 603203,India%Department of Surgery,Johns Hopkins Breast Center at Bayview Campus,4940 Eastern Avenue,Rm.A?562,Baltimore,MD 21224,USA%Center for Evidence?Based and Translational Medicine,Zhongnan Hospital of Wuhan University,Wuhan 430071,China%Department of Diagnostic Ultrasound,Zhongnan Hospital of Wuhan University,Wuhan 430071,China%Department of Surgery,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010110,China%Center for Pathology and Molecular Diagnostics,Wuhan University,Wuhan 430071,China%Department of General Surgery,Fujian Provincial Hospital,Fuzhou 350001,China%The First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China%Key Laboratory of Hepatosplenic Surgery and the First Department of General Surgery,the First Affiliated Hospital of Harbin Medical University,Harbin 150007,China%Department of Breast Surgery,Zhejiang University School of Medicine First Affiliated Hospital,Hangzhou 310003,China%Department of General Surgery,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China%Department of General Surgery,Shanxi Provincial People's Hospital,Taiyuan 030012,China%Department of Breast Surgery,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200092,China%Department of Cardiothoracic Surgery,Zaoyang People's Hospital,Zaoyang 441299,Hubei,China%Department of Thyroid and Breast Surgery,The Second Hospital of Hebei Medical University,Shijiazhuang 050004,China%Department of General Surgery,Guangshan County People's Hospital,Guangshan County,Xinxiang 465499,Henan,China%Department of Breast Surgery,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China%Chinese Academy of Sciences,Beijing 100045,China%Department of General Surgery,School of Clinical Medicine,Tsinghua University,Beijing Tsinghua Changgung Hospital,Beijing 102218,China%Department of Breast and Thyroid Surgery,the First Affiliated Hospital of University of Science and Technology of China,Anhui Provincial Hospital,Hefei 230001,China%Department of Thyroid Surgery,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China%Department of Oncology,Liwan Central Hospital of Guangzhou,Guangzhou 510150,China%Department of Breast Surgery,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China%Department of Computed Tomography,Zhongnan Hospital of Wuhan University,Wuhan 430071,China%Department of General Surgery,Xinxiang Medical University First Affiliated Hospital,Xinxiang 453100,Henan,China%Department of Breast Surgery,Guangxi Medical University Cancer Hospital,Nanning 530021,China%Department of General Surgery,Zhongshan Hospital Fudan University,Shanghai 200032,China%Department of Breast and Thyroid Surgery,Hunan Provincial People's Hospital/the First Affiliated Hospital of Hunan Normal University,Changsha 410005,China%Department of Breast and Thyroid Surgery,Chongqing General Hospital,University of Chinese Academy of Sciences,Chongqing 400013,China%Department of General Surgery,Qinghai Province People's Hospital,Xining 810007,China%Department of Thyroid and Breast Surgery,Qingdao Women and Children's Hospital,Qingdao 266000,Shandong,China%Department of Oncology,Xi'an Jiaotong University Second Affiliated Hospital,Xi'an 710004,China%Department of Cardiothoracic Surgery,Zaoyang First People's Hospital,Zaoyang 441299,Hubei,China%Department of Thyroid and Breast Surgery,Yichang Central People's Hospital,Yichang 443003,Hubei,China%Department of Thyroid Surgery,the Second Affiliated Hospital,Guizhou Medical University,Kaili 556000,Guizhou,China%Department of General Surgery,Shanghai Changzheng Hospital,Shanghai 200003,China%Department of Surgery,Dongfeng General Hospital Affiliated with Hubei Medical College,Shiyan 442001,Hubei,China 2022
• Subjects: Granulomatous mastitis; Treatment; Diagnosis; Granulomatous lobular mastitis; Idiopathic granulomatous mastitis
• ISSN: 2095-7467

Granulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.