Effect of Topical Steroid Treatment on Idiopathic Granulomatous Mastitis: Clinical and Radiologic Evaluation

Abstract Background: This study aimed to evaluate the effectiveness of local steroid treatment (LST) for idiopathic granulomatous mastitis (IGM) and to compare with surgical methods.Methods: Data was retrospectively collected from hospital electronic records. The patients were divided into two groups, the LST group and the surgery group. Intralesional steroid injection and topical steroid administration were applied in LST group. Surgery and LST were compared with regard to: pain before and after the treatment; complication rate; recurrence rate; and treatment cost.Results: Seventy of 72 lesions responded completely to LST. Pre-treatment median maximum diameter was 23.50 (15.25-35.25) mm, which regressed to 16 (12-25) mm after the first LST session. LST was found to be superior to surgery in pain management. No recurrence occurred in any patients in LST group.Conclusion: LST is a treatment for IGM that is cheap, with high efficiency, negligible recurrence, and has good esthetic outcome.

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Treatment Results of Intralesional Steroid Injection and Topical Steroid Administration in Pregnant Women with Idiopathic Granulomatous Mastitis

European Journal of Breast Health ◽

10.4274/ejbh.galenos.2021.2021-2-4 ◽

2021 ◽

Vol 17 (3) ◽

pp. 283-287

Author(s):

Osman Toktas ◽

Nurşen Toprak

Keyword(s):

Pregnant Women ◽

Steroid Injection ◽

Topical Steroid ◽

Granulomatous Mastitis ◽

Treatment Results ◽

Idiopathic Granulomatous Mastitis ◽

Steroid Administration ◽

Intralesional Steroid ◽

Intralesional Steroid Injection

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A Novel First-Line Treatment Alternative for Noncomplicated İdiopathic Granulomatous Mastitis: Combined İntralesional Steroid İnjection with Topical Steroid Administration

Breast Care ◽

10.1159/000507951 ◽

2020 ◽

pp. 1-7

Author(s):

Osman Toktas ◽

Can Konca ◽

Didem Can Trabulus ◽

Aykut Soyder ◽

Hande Koksal ◽

...

Keyword(s):

Steroid Injection ◽

Topical Steroid ◽

Granulomatous Mastitis ◽

Treatment Alternative ◽

First Line ◽

Idiopathic Granulomatous Mastitis ◽

Steroid Administration ◽

Intralesional Steroid ◽

Intralesional Steroid Injection ◽

First Line Treatment

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Local Steroid Treatment: An Effective Procedure for Idiopathic Granulomatous Mastitis, Including Complicated Cases

Journal of Investigative Surgery ◽

10.1080/08941939.2021.1933272 ◽

2021 ◽

pp. 1-7

Author(s):

Taha Furkan Ertürk ◽

Özgür Çakır ◽

Büşra Yaprak Bayrak ◽

Abdullah Güneş ◽

Selahattin Aydemir ◽

...

Keyword(s):

Steroid Treatment ◽

Effective Procedure ◽

Granulomatous Mastitis ◽

Idiopathic Granulomatous Mastitis

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Local Steroid Treatment: An Effective Procedure for Idiopathic Granulomatous Mastitis, Including Complicated Cases

10.21203/rs.3.rs-204310/v1 ◽

2021 ◽

Author(s):

Taha Furkan Ertürk ◽

Özgür Çakır ◽

Büşra Yaprak Bayrak ◽

Abdullah Güneş ◽

Selahattin Aydemir ◽

...

Keyword(s):

Steroid Treatment ◽

Maximum Diameter ◽

Granulomatous Mastitis ◽

Idiopathic Granulomatous Mastitis ◽

Pain Scores ◽

Surgical Methods ◽

Significant Difference ◽

Pre Treatment ◽

Group 2 ◽

Group 1

Abstract Purpose To evaluate the effectiveness of treatment with topical and intralesional steroids for idiopathic granulomatous mastitis (IGM) and to compare with surgical methods.Methods Data was retrospectively collected from records. Intralesional steroid injection and topical steroid administration, hereafter referred to as local steroid treatment (LST) were applied in Group 1. Surgery (local excision, wide excision and mastectomy) was performed in Group 2. In Group 1 changes in lesion sizes were recorded and factors complicating treatment were identified. The Numeric Pain Rating Scale was used to determine subjective pain. LST and surgery were compared with regard to: pain before and after the treatment; complication rate; recurrence rate; and treatment cost.Results There were 38 and 48 patients in Group 1 and Group 2, respectively. In the LST group 72 lesions were present and 70 of 72 (97%) responded completely to treatment. Pre-treatment median maximum diameter was 23.50 (15.25-35.25) mm, which regressed to 16 (12-25) mm after the first session. While the pre-treatment pain scores of Group 1 and Group 2 were similar (p=0.756), there was a significant difference in the post-treatment pain scores (p<0.001). No recurrence occurred in any patients in Group 1, while recurrence developed in 15 (31.2%) patients in Group 2 (p<0.001).Conclusion LST is a treatment for IGM that is cheap, with high efficiency, negligible recurrence, and has good esthetic outcome. Our results suggest that LST should be the first-line treatment option for all IGM patients, including complicated cases.

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Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

Journal of Clinical Medicine ◽

10.3390/jcm10102077 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2077

Author(s):

Yi-Min Huang ◽

Chiao Lo ◽

Chiao-Feng Cheng ◽

Cheng-Hsun Lu ◽

Song-Chou Hsieh ◽

...

Keyword(s):

Disease Severity ◽

Severe Disease ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Serum Biomarkers ◽

Healthy Controls ◽

Granulomatous Mastitis ◽

C Reactive Protein ◽

Idiopathic Granulomatous Mastitis ◽

Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

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Out Come of Wide Local Excision with and without Corticosteroid Therapy in Management of Idiopathic Granulomatous Mastitis

Tumori Journal ◽

10.1177/03008916211012342 ◽

2021 ◽

Vol 107 (1_suppl) ◽

pp. 13-13

Author(s):

R Amira Maher ◽

Ahmed Gamal Eldin Osman ◽

K Fahmy ◽

Shinamwi M ◽

Osama Al Atarash

Keyword(s):

Recurrence Rate ◽

Corticosteroid Therapy ◽

Surgical Excision ◽

Cosmetic Outcome ◽

Systemic Steroid ◽

Granulomatous Mastitis ◽

Idiopathic Granulomatous Mastitis ◽

Palpable Mass ◽

Group A ◽

Group B

Introduction: Idiopathic granulomatous mastitis is a rare benign breast disease. Initial reports from hospitals in Egypt from Departments of Pathology at Cancer Institutes of Cairo, Tanta and Mansoura Universities; indicate that the disease is not as rare as that in the developed countries. It often mimics breast carcinoma both clinically and radiologically. Histological examination is the gold standard for diagnosis. Management of Idiopathic granulomatous mastitis is still debatable. In our study, we aimed to evaluate the addition of corticosteroid therapy to surgical excision in management of idiopathic granulomatous mastitis. Patients and Methods: This is a comparative study was conducted at Ain-Shams University Hospital’s breast clinic on patients with idiopathic granulomatous mastitis from to August 2015 till September 2018. Thirty patients were divided into 2 groups. Group (A) includes patients who underwent surgical management only. Group (B) includes patients who received corticosteroid therapy according to the severity of the cases then surgical Excision was done for the residual lesion. Follow up of all cases up to 1-2 years was done to document the recurrence rate and compare the cosmetic outcome of both groups. Informed consent was obtained from all patients included in the study. Results: The mean age of the affected women was 38.80 and 33.13 in group (A) and group (B), respectively and it wasn’t statistically different (p value = 0.099). The most common presenting symptom was a palpable mass in the breast (66.7% and 93.3%) in group (A) and group (B) respectively. Recurrence rate was higher in group (A) (40%) with no recurrence documented in group (B) however 2 cases were omitted from the study due to steroid noncompliance and complications. Cosmetic outcome was excellent in 76.9% of group (B) and good in 53.3% of group (A). Conclusion: Systemic steroid therapy with surgical resection is the recommended as first-line treatment strategy for IGM as it shows less recurrence rate and surgical scarring. Increased awareness of IGM will increase their understanding and improve their management.

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Idiopathic granulomatous mastitis: challenges of treatment in iranian women

BMC Surgery ◽

10.1186/s12893-021-01210-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Leyla Shojaee ◽

Nasrin Rahmani ◽

Siavash Moradi ◽

Asieh Motamedi ◽

Gholamali Godazandeh

Keyword(s):

Recurrence Rate ◽

Low Dose ◽

Unknown Origin ◽

Surgical Excision ◽

Chronic Inflammatory Disease ◽

High Dose ◽

Granulomatous Mastitis ◽

Idiopathic Granulomatous Mastitis ◽

Results Of Treatment ◽

Information Treatment

Abstract Background and objective As a chronic inflammatory disease of an unknown origin, the treatment of granulomatous mastitis has always been controversial. According to some researchers, surgical treatment and certain medications, especially steroids, are more effective in treating the disease. This study aimed at evaluating the results of treatment in a group of patients with granulomatous mastitis. Materials and methods This longitudinal cohort study evaluated the treatment outcomes of 87 patients with pathology-confirmed granulomatous mastitis referred to the surgical clinic of Central Hospital in Sari, Iran. Demographic, clinical, and pathological information, treatment methods and results, and the recurrence rate were analyzed. Findings A total of 87 female patients with granulomatous mastitis aged 22–52 years with a mean age of 34 years were evaluated. All patients had palpable masses; the breast masses were painful in 48.3% of patients, and 55.2% of patients suffered from erythema and inflammation, and8% had fistulas and ulcers at the inflammation site. The patients were followed-up for an average duration of 26 months (8–48 months) after treatment and recovery. The overall recurrence rate was 24.1%, and the recurrence rate was 29.4% in patients underwent surgery, 34.8% in patients received high-dose prednisolone, and 17% in those received low-dose prednisolone together with drainage (p < 0.001). Conclusions According to the results, the low-dose prednisolone plus drainage was more effective with a lower recurrence rate than only surgical excision or high-dose prednisolone. In fact, the use of minimally invasive methods such as drainage plus low-dose steroids is a more effective method with fewer side effects than the other two methods.

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