J Breast Cancer.  2012 Sep;15(3):371-372. 10.4048/jbc.2012.15.3.371.

Granulomatous Mastitis during Chronic Antidepressant Therapy: Is It Possible a Conservative Therapeutic Approach?

• Bellavia M
• Damiano G
• Palumbo VD
• Spinelli G
• Tomasello
• Marrazzo A
• Ficarella
• Bruno A
• Sammartano A
• Fiorentini T
• Scio A
• Maione C
• Lo Monte A

• KMID: 2286466
• DOI: http://doi.org/10.4048/jbc.2012.15.3.371

Abstract

Granulomatous mastitis is a rare benign inflammatory disease of the breast with multiple etiologies such as tuberculosis, sarcoidosis, foreign body reaction, and mycotic and parasitic infections. In contrast, idiopathic granulomatous mastitis (IGM) is characterized by the presence of chronic granulomatous lobulitis in the absence of an obvious etiology. Clinically and radiologically it may mimic breast carcinoma and so awareness of surgeons, pathologists, and radiologists is essential to avoid unnecessary mastectomies. Cases of IGM are reported during antidepressant therapy in patients also showing high levels of prolactinemia. In these cases, we believe that surgical excision must be avoided being replaced with a conservative management of the pathological condition based on a corticosteroid treatment.

Keyword

Antidepressant therapy; Hyperprolactinemia; Idiopathic granulomatous mastitis; Selective serotonin reuptake inhibitors

MeSH Terms

Breast
Foreign-Body Reaction
Granulomatous Mastitis
Humans
Hydrazines
Hyperprolactinemia
Immunoglobulin M
Mastectomy
Sarcoidosis
Serotonin Uptake Inhibitors
Tuberculosis
Hydrazines
Immunoglobulin M
Serotonin Uptake Inhibitors

Reference

1. Ocal K, Dag A, Turkmenoglu O, Kara T, Seyit H, Konca K. Granulomatous mastitis: clinical, pathological features, and management. Breast J. 2010. 16:176–182.

2. Ozel L, Unal A, Unal E, Kara M, Erdoğdu E, Krand O, et al. Granulomatous mastitis: is it an autoimmune disease? Diagnostic and therapeutic dilemmas. Surg Today. 2012. 42:729–733.

3. Marrazzo A, Taormina P, Marrazzo E, Palumbo VD, Damiano G, Maione C, et al. The sentinel node biopsy is not contraindicated in multifocal breast carcinoma. Eur J Oncol. 2011. 16:105–110.

4. Wieck A, Haddad PM. Antipsychotic-induced hyperprolactinaemia in women: pathophysiology, severity and consequences. Selective literature review. Br J Psychiatry. 2003. 182:199–204.

5. Amsterdam JD, Garcia-España F, Goodman D, Hooper M, Hornig-Rohan M. Breast enlargement during chronic antidepressant therapy. J Affect Disord. 1997. 46:151–156.

6. Albizu L, Holloway T, González-Maeso J, Sealfon SC. Functional crosstalk and heteromerization of serotonin 5-HT2A and dopamine D2 receptors. Neuropharmacology. 2011. 61:770–777.

7. Lukasiewicz S, Polit A, Kedracka-Krok S, Wedzony K, Maćkowiak M, Dziedzicka-Wasylewska M. Hetero-dimerization of serotonin 5-HT (2A) and dopamine D(2) receptors. Biochim Biophys Acta. 2010. 1803:1347–1358.

8. Erhan Y, Veral A, Kara E, Ozdemir N, Kapkac M, Ozdedeli E, et al. A clinicopthologic study of a rare clinical entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast. 2000. 9:52–56.

9. Coker F, Taylor D. Antidepressant-induced hyperprolactinaemia: incidence, mechanisms and management. CNS Drugs. 2010. 24:563–574.

10. Spigset O. Adverse reactions of selective serotonin reuptake inhibitors: reports from a spontaneous reporting system. Drug Saf. 1999. 20:277–287.

11. Lai EC, Chan WC, Ma TK, Tang AP, Poon CS, Leong HT. The role of conservative treatment in idiopathic granulomatous mastitis. Breast J. 2005. 11:454–456.

12. Willis SL, Ramzy I. Analysis of false results in a series of 835 fine needle aspirates of breast lesions. Acta Cytol. 1995. 39:858–864.