| OBJECTIVE:To analyze retrospectively granulomatous mastitis cases in our hospital and domestic core journals reported, in order to understand the characteristics of the disease, diagnosis, treatment and follow-up, raise awareness of granulomatous mastitis, accumulate clinical experience, and provide reference for future clinical work.METHODS:Use "granulomas", "mastitis" as the keywords to search CNKI, Wangfang data, CQVIP for articles on granulomatous mastitis cases published during 1986-2015 in domestic Chinese science and technology core journals. Collect granulomatous mastitis patients from May 2009 to January 2015 in the Galactophore Dept in Dongfang Hospital, the Second Affiliated Hospital of Beijing University of Chinese Medicine, and the patients were followed by clinic or telephone. Then compare the patients with cases reported in the articles, analyze their clinical manifestations, relevant examination and treatment through retrospectively, finally summarize clinical experience.RESULTS:1. A total of 2770 cases is reported from 1986 to 2015 in 98 selected articles on the diagnosis and treatment of granulomatous mastitis, including 7 male cases (0.25%),2763 female cases (99.75%), age range from 16-77 years old, the average age was 33.96 years. A total of 54 cases were collected in our hospital, and they are all female patients, with age range from 24-50 years old,31-35 years is the most common age.2.96.3% patients in our hospital has a history of pregnancy-labor,79.6% has a history of breast-feeding. While 97.8% cases reported in the articles have a history of pregnancy-labor, 93.2% has a history of breast-feeding, the disease is tend to happen 3-5 years later after they stopped breast-feeding.3. Among the 54 cases in our hospital,4 cases have the history of mastitis,1 patient has the history of pituitary adenoma. In Cases reported in the articles there are 38 cases have the history of mastitis,42 cases have the history of breast trauma,13 patients with a history of taking oral psychotropic drugs,49 patients with a history of taking oral contraceptives,5 patients have a history of pituitary adenoma,2 patients have the history of hyperprolactinemia.4.41 patients in our hospital underwent hormone examination,12 cases’(29.3%) prolactin is above the normal range.19 patients (35.2%) is overweight,12 patients (22.2%) is obese, 35.7% patients has dyslipidemia.5. The courses of patients in our hospital range from 4 days to 4 years, with an average of 5.83±.18 months; The courses of cases reported in the articles range from 2 days to 10 years, with an average of 7.5 months.6. Among the patients in our hospital,7 patients (13.0%) are bilateral, while among cases reported in the articles,23 cases is bilateral. Among the patients in our hospital,45 patients (83.3%) is involving two or more quadrants, while among cases reported in the articles,122 cases (29.4%) is involving two or more quadrants.The average length of the tumor found in our hospital is 8.36cm, while the figure reported in the articles is 4.20cm. Among the patients in our hospital,44.4% of the disease is located in the left breast and 42.6% is located in the right breast; while among cases reported in the articles,56.6% reported to be located in the left breast,43.3% in the right breast. Among the patients in our hospital, only 10 cases’ (18.5%) chief complaint is merely breast lump,26 patients (48.1%) is in the collapse late period,26 patients (48.1%) have already formed sinus tract, and 18 patients (33.3%) required incision and drainage of abscess formation.7. Among the patients in our hospital,16 patients (29.6%) have axillary lymph nodes, while among cases reported in the articles,399 cases have axillary lymph nodes. Among the patients in our hospital,19 patients (35.2%) have nipple deformity and 4 patients (7.4%) have the nipple overflow; while among cases reported in the articles,255 cases have nipple deformity and 106 cases have the nipple overflow.8. Among the 24 patients in our hospital doing the bacterial culture tests,4 cases (16.7%) were found positive; while among cases reported in the articles 23 cases were found positive.9. The misdiagnosed cases reported in the articles is mostly breast cancer,322 cases were reported. 10.54 patients were using both traditional Chinese medicine treatment and surgical treatment, 2 cases (3.7%) relapse, and were cured by segmentectomy, with no secondary recurrence. CONCLUSIONS:1. In the past 5 years, the report of cases has increased sharply, which suggests that the incidence of this disease is increasing and the understanding of this disease is increasing.2. GM is more prevalent in women, with a large age span from youth to old age, but relatively concentrated in thirties. This is considered to be related to the pathogenesis of GM. Parous women is the main population of GM.3. Prolactin elevation, obesity, dyslipidemia, mastitis, history of medicine food allergy history, oral contraceptive history, breast trauma history that may be relevant factors in the pathogenesis of GM.4. GM is characterized by sudden onset, rapid progression, and refractory. Most courses of the disease are 3 months.5. In the four quadrants of the breast, lumps on the upper outside quadrant is significantly different from the other three quadrants, and this is also considered to be related with the glands’thickness in different quadrants.6. GM patients may be associated with erythema, axillary lymph nodes, nipple abnormalities, nipple discharge and other symptoms associated with.7. The recurrence rate of GM patients in our hospital was low, and the effect of surgery combined with traditional Chinese medicine was significant. |
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