‘ONCOPLASTY – THINK BEYOND MALIGNANCY’- ADOPTING ONCOPLASTIC BREAST SURGERY(OBS) PRINCIPLES FOR THE SURGICAL MANAGEMENT OF IDIOPATHIC GRANULOMATOUS MASTITIS(IGM) megu92@gmail.com

 

‘ONCOPLASTY – THINK BEYOND MALIGNANCY’- ADOPTING ONCOPLASTIC BREAST SURGERY(OBS) PRINCIPLES FOR THE SURGICAL MANAGEMENT OF IDIOPATHIC GRANULOMATOUS MASTITIS(IGM)

4

India

Oral or Poster

IGM, a chronic inflammatory condition resembling breast cancer, causes diagnostic challenges for surgeons. Ambiguous pathophysiology, no consensus on management and high recurrence underscore its severity. We applied OBS principles for surgical management of IGM to study its effects on symptom resolution, recurrence, complications and cosmesis.

In this ambispective study, all patients diagnosed with IGM received tapering doses of oral steroids (OS). Patients with partial/no response or progression with OS were planned for surgery. Based on size of residual disease, were divided into two groups. Study group was patients who underwent WLE + OBS and comparator group- who underwent WLE only. Symptom resolution, recurrence rates, complication rates and patient-reported outcomes concerning breast shape, symmetry, and scars(using standardized questionnaire) were assessed in both groups.

142 patients included; 37 resolved with OS, 105 underwent surgery. 49.5% (n=52) with large, skin-involved, multiquadrant tumours underwent level I/II OBS, while 50.5% (n=53) with smaller, single-quadrant tumours had WLE. 17 had recurrence in the 18-month follow-up period. OBS group had statistically significantly lower recurrence rate, ie n= 3(p< 0.006). Better outcomes in appearance, symmetry, and scars observed with OBS group despite larger volume of excision without an increase in complication rates. Our oncoplastic techniques included a plethora of dermoglandular, perforator, transposition and latissimus dorsi flaps.

Applying oncoplastic principles to surgically manage IGM- an often disfiguring benign breast disease gives breast surgeons the liberty to excise wider margins without compromising on the breast appearance, leading to low recurrence rates, simultaneously providing excellent patient-related outcomes.