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

Ertürk, Taha Furkan; Çakır, Özgür; Bayrak, Büşra Yaprak; Güneş, Altan; Aydemir, Selahattin; Utkan, Nihat Zafer

doi:10.1080/08941939.2021.1933272

Cited by 12 publications

(11 citation statements)

References 32 publications

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“…However, systemic side effects were observed at a very low rate, as 9.4% of the patients received systemic treatment, which might be due to the relatively shorter duration of systemic exposure to steroids for a maximum of 3 months in their study. Ertürk et al further reported that 2 of 38 patients developed hematoma after LSI ( 23 ). However, patients in other reports and in the present study were found to have a higher rate of steroid-related systemic side effects, even though patients in our study were treated with a low-dose peroral steroid regimen for a maximum period of >6 months in a few cases in the systemically treated group.…”

Section: Discussionmentioning

confidence: 98%

Local steroid injection in severe idiopathic granulomatous mastitis as a new first-line treatment modality with promising therapeutic efficacy

Cabioglu,

Uras,

Mutlu

et al. 2023

Front. Med.

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BackgroundIntralesional steroid injection has recently evolved as a novel treatment modality for localized idiopathic granulomatous mastitis (= IGM). We aimed to explore the therapeutic efficacy of local steroid injections (LSI) in patients with severe IGM.MethodsFifty-one patients diagnosed with severe IGM were included in the study and treated with either local steroid injection (LSI) alone (n = 25) or combined LSI with systemic oral steroid treatment (OST) (n = 26). The local steroid injection protocol included an intralesional triamcinolone acetonide injection into the palpable granulomas every 4-week, and topical administration of steroid-containing pomades twice a day on the affected surface of the breast. Patients with a combined LSI and OST received low-dose oral methylprednisolone (<16 mg).ResultsPatients with LSI alone required more LSI applications than those in the combined LSI with OST group (LSI: 5 ± 2.9; vs. LSI/OST: 3.5 ± 2.5; p = 0.080) to obtain an effective optimum therapeutic response. At a median of 12 months (range, 4–42), no difference was found in complete response rates between patients in the LSI group and the combined LSI group with OST (52 vs. 53.9%, p = 0.999). However, steroid-related systemic side effects were lower in the LSI alone group (p < 0.008).ConclusionLocal steroid injection could be considered as the first-line treatment in patients with severe IGM until a therapeutic response has been obtained either as the sole treatment modality or combined with oral steroids. Compared with systemic oral steroid therapy, local steroid administration can be considered a new treatment modality with fewer side effects.

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Section: Discussionmentioning

confidence: 98%

Local steroid injection in severe idiopathic granulomatous mastitis as a new first-line treatment modality with promising therapeutic efficacy

Cabioglu,

Uras,

Mutlu

et al. 2023

Front. Med.

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“…Healing of the disease with no recurrence in patient follow-up constitutes effective therapy of GM [ 76 ]. Surgical excision, including wide surgical resection, mastectomy with or without rapid breast reconstruction, frequent abscess drainage, antibiotics, topical or systemic corticosteroids treatment, immunosuppression with MTX, and close observation are among the treatment options [ 15 , 37 , 41 , 43 ]. Several studies suggest that the disease will improve by itself through Observation alone [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment modalities for granulomatous mastitis, seeking the most appropriate treatment with the least recurrence rate: a systematic review and meta-analysis

Sarmadian,

Safi,

Sarmadian

et al. 2024

Eur J Med Res

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Background Granulomatous mastitis (GM) is a rare, benign, inflammatory breast disease with an unknown etiology that predominantly affects women of reproductive age. The definitive treatment of GM is currently controversial; an appropriate therapeutic strategy has yet to be identified, and the disease’s high recurrence rate remains. This study aims to determine the recurrence rate for each GM treatment strategy to identify the most appropriate treatment modality. Methods The search for relevant articles was undertaken using three international databases, including Medline, Scopus, and Web of Science. Articles published in English until the end of 2021 evaluating the recurrence rate of GM were included. Using Stata 13.0, the pooled incidence and 95% confidence interval (CI) for the recurrence rate were determined. Results Sixty-five eligible studies were included in our study. The recurrence rates of systemic steroid use, topical steroid use, antibiotic use, methotrexate use, observation, drainage, excision, antibiotic use and surgery, steroid use and surgery, antibiotic and steroid use, methotrexate and steroid use were 24% (95% CI: 21–27%), 11% (95% CI: 6–21%), 18% (95% CI: 14–22%), 13% (95% CI: 7–22%), 11% (95% CI: 7–17%), 65% (95% CI: 50–78%), 13% (95% CI: 10–16%), 23% (95% CI: 14–36%), 7% (95% CI: 5–11%), 11% (95% CI: 6–18%), and 4% (95% CI: 2–8%), respectively. Drainage had the highest recurrence rate, while combined methotrexate and steroid treatment had the lowest rate. Conclusion The optimal treatment strategy for GM depends on the disease’s severity, consequences, and the patient's features. The study results indicate that combination therapy is preferable for minimizing the risk of relapse and reducing treatment complications.

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“…The etiology and pathogenesis of GLM are still poorly understood. Current surgical procedures and medical treatments for GLM are frequently accompanied by numerous complications and a high recurrence rate ( 20 , 21 ). In recent years, technologies such as noninvasive biomarkers and miRNA chips have emerged, which may contribute to the diagnosis of diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Drugs for the treatment of GLM are currently under investigation. Although no consensus has been reached on the selection of drugs, corticosteroids ( 20 , 25 , 26 ) and methotrexate ( 27 , 28 ) have been widely used in the treatment of GLM. GLM is considered to be an autoimmune inflammatory disease due to the marked clinical treatment effect of immunosuppressants.…”

Section: Discussionmentioning

confidence: 99%

Differential expression profiles of miRNA in granulomatous lobular mastitis and identification of possible biomarkers

et al. 2022

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The etiology and pathogenesis of granulomatous lobular mastitis (GLM) remain largely elusive and the expression levels and regulatory roles of microRNAs (miRNAs or miRs) in GLM have remained mostly undetermined. In the present study, the miRNAs that were differentially expressed in breast biopsy samples from patients with GLM and normal tissue adjacent to fibroadenoma were analyzed, a comprehensive differential expression profile of miRNAs was provided and potential biomarkers were screened out. The expression profile of miRNAs was determined by high-throughput sequencing in the tissues of patients with GLM and healthy controls. Significantly differentially expressed miRNAs were screened by threshold setting and cluster analysis and their target genes were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Finally, circulating differentially expressed miRNAs between the GLM and control groups were further analyzed by reverse transcription-quantitative PCR (RT-qPCR). A total of 31,077 miRNAs were detected by high-throughput sequencing. By using the cutoff criteria of |log2 fold change|>2.5 and q<0.001, 13 miRNAs that were indicated to be GLM biomarkers were screened out. The expression levels of these 13 miRNAs in the GLM group were higher than those in the control group. GO and KEGG enrichment analyses suggested that the occurrence and development of GLM may be associated with autoimmune inflammation, metabolism and pathogenic organisms. miR-451a and miR-5571-3p were confirmed to be significantly increased in the serum of patients with GLM compared with their levels in the serum of healthy volunteers, which suggests that they may be used as biomarkers of GLM. To the best of our knowledge, the present study was the first report detailing genome-wide miRNA profiling of patients with GLM compared with controls. The possible targets and pathways of GLM were evaluated by bioinformatics analysis. The present study identified 13 differentially expressed miRNAs with important theoretical significance and potential application. Furthermore, miR-451a and miR-5571-3p were verified by RT-qPCR as possible biomarkers of GLM.

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

Cited by 12 publications

References 32 publications

Local steroid injection in severe idiopathic granulomatous mastitis as a new first-line treatment modality with promising therapeutic efficacy

Local steroid injection in severe idiopathic granulomatous mastitis as a new first-line treatment modality with promising therapeutic efficacy

Treatment modalities for granulomatous mastitis, seeking the most appropriate treatment with the least recurrence rate: a systematic review and meta-analysis

Differential expression profiles of miRNA in granulomatous lobular mastitis and identification of possible biomarkers

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