الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
This study was conducted on 30 female patients admitted to the surgical oncology unit at faculty of medicine, Alexandria University. They all were diagnosed as IGM either via core needle or open surgical biopsy. The aim of the study was to evaluate the role of systemic corticosteroid therapy in treatment of IGM and correlate this with the clinical outcome and sonographic findings.
The age of patients ranged between 23-55 years. Third of our patients gave recent history of pregnancy or lactation in the last 5 years. 13 of cases had history of oral contraceptive pill use (combined type) now or within the last two years. Family history of similar conditions was present only in one case. While 11 cases had past history of similar attacks whether in the form of simple mastitis or breast abscess.
Painful breast mass (28 cases) was the commonest presentation in our study. Breast abscess was in 5 cases. Axillary lymphadenopathy was associated in 12 cases. Skin changes like erythema (in 8 cases) and peau d, orange (in 3 cases) were also observed. Nipple purulent discharge was noted in 7 patients, while discharging skin sinuses were found in 3 cases.
The most common mammographic sign was focal asymmetrical increased breast density presented in 24 cases while breast mass was in 6 patients. On US examination, breast mass was present in 22 case, with axillary LN involvement in 20 cases.
Our treatment plan was to give oral corticosteroid therapy at a dose of 60 mg prednisolone daily divided at two times (40 mg morning and 20 mg evening),then gradual tapering of the dose according to patient response . Clinical and sonographic assessment were done monthly.
After three months, 9 cases showed good response clinically (pain and skin signs improvement) and songraphically (absence of breast mass), while 8 patients showed partial response (decrease in mass size) and those were submitted to another 3 months of treatment and showed good response at the end. 13 of the cases showed poor or no response and preferred to undergo wide local excision of the breast mass after the first three months.
We noticed that recent pregnancy or lactation and history of oral contraceptive pill intake may be risk factors for resistance to steroid treatment and prolongation of treatment period.
Also, two cases of the 9 cases of initial recovery showed recurrence after one year of their recovery and were treated by oral corticosteroids.