| Purpose:To investigate the clinical characteristics of granulomatous lobular mastitis(GLM),guide diagnosis and treatment,and analyze recurrence risk factors.Methods:retrospectively analyzing Clinical data of 121 patients with granulomatous lobular mastitis admitted to the department of breast surgery,the first affiliated hospital of nanchang university from January 2007 to June 2018 and summarizing their clinical characteristics,treatment and prognosis.Results:There were 121 patients who met the inclusion criteria and their age of onset was(33.36±8.28)years,marital history: 119 cases(98.35%)were married and 2 cases(1.65%)were unmarried.Clinical manifestations: there were 117 cases(96.69%)of first symptom masses,2 cases(1.65%)of pain,1 case(78.51%)of effusion,and 1case(0.83%)of others.Among these patients with definite symptoms,there were49 cases(40.50%)with lesions around the breast.There were 63 cases(52.07%)near the areola,4 cases after the areola,4 cases below the areola,and 1 other case in the central area of the breast.82 cases(67.77%)had pain sensation,and 39 cases(32.23%)had no pain sensation.There were 13 patients with nipple discharge,which could be pale yellow,bloody.There were 21 patients with nipple retraction,accounting for 17.36%.In this study,there were 59 cases of pus,including 6 cases with fistula formation and 62 cases without pus.Body condition: temperature: normal119 cases(accounting for 90.91%),Fever 11 cases.Abnormal blood routine 26 cases,normal 95(0.83%)cases.109 cases underwent preoperative color doppler ultrasound examination,and the results were: 10 cases(9.17%)with suspicious cancer,70 cases with inflammation and abscess,15 cases with benign non-inflammatory occupation,and 7 cases with normal.Among the 121 cases,37 underwent preoperative mammography,and the results were 7(18.9%)cases of suspected cancer,2 cases of inflammation,21 cases of benign,and 7 cases of uncertainty.Treatment: preoperative hormone therapy was used in 42 cases,55 patients were treated with antibiotics,There were 27 patients who underwent local surgical resection,among which 1patient had recurrence.Of the 82 patients who underwent extensive resection,6patients had recurrence.The total recurrence rate is 6.4%.According to the analysis and statistics of the influential factors of recurrence,there was no statistical difference between the age and whether the lesion formed pus and the recurrence(P>0.05).There was also no significant difference in postoperative local recurrence between the two surgical methods(P>0.05).Complications: incision infection or abscess in 7 cases,and fat liquefaction in 2 case.Conclusion:Patients with granulomatous lobular mastitis tend to occur in women of child-bearing age,and lumps with pain are the most common symptoms.The lesions were mostly located in the periphery of the breast and the areola of the central breast region.Most patients have no obvious systemic inflammatory reaction.The clinical manifestation of this disease is similar to that of breast cancer,Differentiation from breast cancer should be emphasized.Surgical removal of the lesion can reduce the risk of recurrence of the disease and is an effective method for treatment of the disease.Analysis of influencing factors of local recurrence: there was no statistical difference in age,whether the lesion formed pus or not,and the surgical method for local recurrence. |
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