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What predicts the recurrence in ıdiopathic granulomatous mastitis?

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Abstract

Introduction

Idiopathic granulomatous mastitis (IGM) is a rarely seen chronic and benign disease of the breast. IGM usually emerges in women between 30 and 45 years of age and within the first 5 years after lactation. There is no consensus on the treatment of the disease. Steroids, immunosuppressive agents such as methotrexate and azathioprine, antibiotics, and surgical and conservative treatments can be preferred. In the present study, it was aimed to demonstrate the treatment options and follow-up data of the patients with IGM and to investigate the effective factors on recurrence if developed in the follow-up period.

Materials and method

The data of 120 patients diagnosed with idiopathic granulomatous mastitis were evaluated for this cross-sectional retrospective study. The demographic, clinical, treatment, and follow-up features of the patients were obtained from the file records.

Results

The median age value of the 120 female patients included in the study was 35 (24–67) years. Of the patients, 45%, 79.2%, 49.2%, and 15% had a past history of surgical intervention, steroid use, methotrexate use, and azathioprine use, respectively. Recurrent lesion developed after the treatment in 57 (47.5%) patients. The recurrence rate was 66.1% in the patients who underwent surgical intervention in the initial treatment. There was a statistically significant difference between the patients with and without recurrence regarding the presence of abscess, the presence of recurrent abscess, and having surgical intervention as the initial treatment in the past history. The rate of having surgery was statistically significantly higher compared with the administration of steroid therapy alone and the combination of steroid and immunosuppressive therapy in the initial treatment of the patients who developed recurrence. The rate of having surgery together with the administration of steroid and immunosuppressive therapy was statistically significantly higher than the administration of steroid and immunosuppressive therapies.

Discussion

Our study showed that surgical intervention and the presence of abscess increased recurrence in the treatment of IGM.

Key Points

• This study has shown that surgical intervention and the presence of abscess increase recurrence.

• A multidisciplinary approach to the treatment of IGM and management of the disease by the rheumatologists may be critical.

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Authors and Affiliations

  1. Division of Rheumatology, Uludag University Faculty of Medicine, Görükle Kampüsü, 16059, Nilüfer, Bursa, Turkey

    Nihal Lermi, Ali Ekin, Tuğba Ocak, Zeynep Yılmaz Bozkurt, Burcu Yağız, Belkıs Nihan Coşkun, Yavuz Pehlivan & Ediz Dalkılıç

  2. Department of Internal Medicine, Uludag University Faculty of Medicine, Bursa, Turkey

    Mehmet Akif Ötegeçeli

Authors
  1. Nihal Lermi
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  2. Ali Ekin
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  3. Tuğba Ocak
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  4. Zeynep Yılmaz Bozkurt
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Contributions

Each author’s contribution to this article is explained below: Nihal Lermi is the owner of the research topic and organized the research team. Nihal Lermi and Belkıs Nihan Coşkun were responsible for the writing of the article. Nihal Lermi, Ali Ekin, Tuğba Ocak, Zeynep Yılmaz Bozkurt, and Mehmet Akif Ötegeçeli reached the patients’ data. Burcu Yağız and Yavuz Pehlivan were responsible for the statistics of the study. Nihal Lermi, Burcu Yağız, and Belkıs Nihan Coşkun reviewed the literature. Yavuz Pehlivan and Ediz Dalkılıç designed the study, analyzed data, and approved the version to be published.

Corresponding author

Correspondence to Nihal Lermi.

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Ethical approval

This study was conducted in accordance with the Declaration of Helsinki and approved by the local ethics board Uludag University Medical Faculty ethics committee approval dated 04.11.2020 and numbered 2020–19/32.

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Lermi, N., Ekin, A., Ocak, T. et al. What predicts the recurrence in ıdiopathic granulomatous mastitis?. Clin Rheumatol 42, 2491–2500 (2023). https://doi.org/10.1007/s10067-023-06651-3

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