Gamal M SAIED
Cairo university, Egypt
Title: Satisfactorily Responds to Antituberculous Treatment: Surgery Has no Role in the Management of Idiopathic Granulomatous &Tuberculous Mastitis in Egyptian Women Population. A Recent Study
Biography:
Professor of Surgery, Faculty of Medicine, Cairo University. Ex-Head of Surgical Oncology Unit & Ex–Director of the Emergency and Causalities Hospital and Member of the Board of Administration, Cairo University Hospitals. Chairman of the Professors Upgrading Committee (General Surgery, 2016- ….). Member of : NESA, EACR, ASCO. Member of the Scientific Council for the Egyptian Fellowship in General Surgery, Ministry of Public Health & Population. Laureate the Egypt State's Award for Medical Sciences . Decorated the Order of Merit (First Class) from the President of the Arab Republic of Egypt
Abstract:
Background:Rare, having no clear etiology, idiopathic granulomatous mastitis (IGM) and its variant tuberculous mastitis (TM) are chronic inflammatory lesions usually picked up on clinical suspicion. Mammosonography and needle biopsy display nonspecific features but may provide additional diagnostic support. Patients vary in presentation and their treatment may be instituted on empirical basis.
Cases and Methods:Three cases of IGM were referred for treatment in a year. Diagnosis was made on clinical suspicion, supported by mammosonography and needle biopsy. TM was first thought for and specific treatment was given empirically following the Egyptian guidelines approved by the WHO. The acid fast bacilli were not detected in the 3 cases.
Results: The given 6 months antituberculous treatment (ATT) produced progressive reduction in the size of the masses with amelioration of the preexisting breast symptoms. Follow-up radiology showed parallel results and the lesions disappeared at the end of the course. Conclusion Some cases of IGM are tuberculous, and both may mimic malignancy. In Egyptians TM should be considered first, and ATT can be safely instituted on empirical basis if the clinical data are sufficient. Cure is expected within 6 months and early treatment failure, dictates shifting to drugs for genuine IGM. It is not necessary to see the acid fast bacilli in tissue specimen or in culture.