Background: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory breast condition with unknown etiology. Different treatments including corticosteroids have been recommended with no universal consensus. In this study we evaluated the efficacy of low dose vs. high dose prednisolone in treatment of IGM. Methods: In this randomized clinical trial, 30 female patients with IGM were randomly allocated to receive low dose or high dose prednisolone. First group received 5 mg daily prednisolone, while the second group received 50 mg for three days, 25 mg for the next three days and then 12.5 mg for further three days and 5 mg daily afterwards, both for two months. Patients were evaluated 2, 3, 6 and 12 months after treatment. The success and recurrence rate was compared between groups. Results: High dose group had significantly higher rate of remission compared to low dose group (93.3% vs. 53.3%, p=0.03). One patient in high dose group and 5 patients in low dose group underwent lumpectomy due to persistent symptoms. Two other patients in low dose group received high dose treatment after three months due to no change in symptoms. Among patients with remission, recurrence was also significantly lower in high dose compared to low dose prednisolone (0% vs. 37.5%, p=0.04). Conclusion: High dose prednisolone has high success rate with lower recurrence in the treatment of IGM and could reduce the need for surgery. However, further studies are necessary to confirm these findings.

Objectives: Prediction of nausea and vomiting can positively contribute to the management of this post-anesthesia adverse effect. Therefore, the present study aimed to design and implement a checklist for predicting anesthesia-induced nausea and vomiting in candidate patients for mastectomy. Materials and Methods: This methodological study was conducted on 300 candidate patients for mastectomy during 2018-2019 at Imam Reza hospital, Tabriz, Iran. The checklist items were designed and developed based on scientific articles, expert opinions, and patient interviews. The Pearson correlation coefficient, Cronbach’s alpha, Spearman-Brown coefficient, factor analysis, the KaiserMeyer-Olsen measure of sampling adequacy, and VARIMAX rotation were used to analyze the data. Eventually, the distribution of data with a normal distribution was compared through the Kolmogorov-Smirnov test. Results: In the first stage, 100 items were collected, which were reduced to 35 cases after modification by a team of experts. Twenty items were ultimately selected after observing the 80/20 response rate. The overall scale reliability was calculated as 0.953 based on Cronbach’s alpha. The correlation coefficient of the first and second implementations was 0.853. Finally, the four extracted factors accounted for 69.51 of the variance of the checklist based on factor analysis. Conclusions: The prediction checklist for post-anesthesia nausea and vomiting in candidate patients for mastectomy comprised adequate psychometric indicators that could be used with high reliability according to the extracted indices.

Objectives: Tumor size and axillary lymph node (LN) involvement are used as prognostic markers and a guide for choosing adjuvant therapy. This study aimed to evaluate LN involvement and related risk factors in patients with breast cancer (BC) referred for radiotherapy. Materials and Methods: Using the census sampling method, 15,000 women with BC referring for radiotherapy were enrolled in this retrospective descriptive study performed at Tabriz University of Medical Sciences during 2000-2020. LN involvement and related risk factors were recorded and analyzed using the t test and ANOVA test at a significance level of P<0.05. Results: The prevalence of LN involvement in this study was 25%. The estrogen receptor status and LN involvement were associated with metastasis. The odds ratio of metastasis in patients with a negative estrogen receptor was about twice that of women with estrogen receptor positivity. Finally, the risk of metastasis in patients presenting with LN involvement was eight times higher than that of patients without LN involvement. Conclusion: In general, estrogen receptor status and LN involvement were associated with metastasis in patients with BC. Thus, these factors can be regarded as a guide to start necessary interventions earlier in at-risk patients.