Management of Patients with Idiopathic Granulomatous Mastitis: Presentation of 13 Cases

Çalış, Hasan; Karakoyun, Rojbin; Aslaner, Arif; Gündüz, Umut Rıza; Arıcı, Cumhur

doi:10.5152/tjbh.2014.1907

Cited by 6 publications

(3 citation statements)

References 20 publications

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“…33 studies (55.9%) mentioned ethical approval sought to perform the study: Ahmed, 2016; Alper, 2020; Altunkeser, 2019; Berkesoglu, 2021; Bouton, 2015; Cetin, 2019; Cetinkaya, 2020; Chen, 2021; Chirappapha, 2018; Cornejo-Juarez, 2014; Dalbasi, 2021; Davis, 2019; Erturk, 2021; Farouk, 2017; Fayed, 2019; Joseph, 2014; Kafadar, 2021; Karanlik, 2014; Kiyak, 2014; Maher, 2021; Oak, 2021; Pandey, 2014; Postolova, 2020; Sakurai, 2011; Shin, 2017; Shojaee, 2021; Tan, 2019; Tekgoz, 2020; Toktas, 2021; Wang, 2020; Yabanoglu, 2015; Zhang, 2019; Zhang Xiaohui, 2020. The Çaliş, et al, 2014 and Deng, et al, 2017 studies described no ethical approvals sought, but patients included in the studies had provided written consent ( 40 , 77 ). The remaining 24 studies (40.7%) did not mention any ethical approval: Akahane, 2013; Akcan, 2014; Aldaqal, 2004; Alrayes, 2019; Altintoprak, 2015; Atak, 2015; Atalay, 2011; Dag, 2021; Elzahaby, 2016; Erhan, 2000; Eser, 2013; Gunduz, 2014; Gurleyik, 2012; Hur, 2013; Kayahan, 2012; Kundaktepe, 2021; Lai, 2005; Liao, 2020; Mawla, 2020; Neel, 2013; Ocal, 2010; Sen Oran, 2013; Skandarajah, 2015; Wang, 2021.…”

Section: Resultsmentioning

confidence: 99%

A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention

Ong,

Ho,

Liow

et al. 2024

Front. Med.

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PurposeThe major aim of our meta-analysis was to review the effectiveness of various treatment modalities for achieving successful remission and preventing recurrence for women with idiopathic granulomatous mastitis (IGM). This knowledge is instrumental in developing evidence-based guidelines for clinicians to improve management strategies and outcomes for patients with IGM.MethodsA systematic literature search was performed on MEDLINE (Ovid), Embase (Elsevier), PubMed, Cochrane Library, Web of Science, and Google Scholar; studies published to 19 January 2022 were included. A meta-analysis of 57 observational studies was performed. The results of two randomized controlled trials were also examined.ResultsThere were 3,035 IGM patients across the observational and randomised studies. Overall recurrence and remission rates across all treatment strategies in 59 studies are 87.9% (2,667/3035) and 13.5% (359/2667), respectively. The studies reported 19 different treatment strategies, comprising observation, medical monotherapies, surgery, and combinations involving medical therapies, with and without surgery. Among monotherapy treatment, surgical management had the highest pooled remission rate (0.99 [95% confidence interval (CI) = 0.97–1.00]); among combination therapy, this was steroids and surgery (0.99 [0.94–1.00]). Antibiotic monotherapy had the lowest remission rate (0.72 [0.37–0.96]). The highest recurrence rates belonged to treatments that combined antibiotics and surgery (0.54 [0.02–1.00]), and antibiotics, steroids, and surgery (0.57 [0.00–1.00]). Most successful for preventing recurrence were observation (0.03 [0.00–0.10]), methotrexate (0.08 [0.00–0.24]), and steroids and surgery (0.05 [0.01–0.12]). There is a significant association between longer follow-up duration and recurrence rate reported, p = 0.002.ConclusionCombination therapies, especially those incorporating antibiotics, steroids, and surgery, have demonstrated higher remission rates, challenging the use of antibiotic monotherapy. There is an increased emphasis on the need for personalised, multi-pronged approach for preventing IGM recurrence, with longer follow-up care. More prospective future work in IGM research, with standardised diagnostic criteria, treatment protocols, and reporting guidelines will be important for developing treatment protocols and guidelines clinicians can adhere to in the clinical management of IGM patients.Systematic review registration: PROSPERO (CRD42022301386).

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Section: Resultsmentioning

confidence: 99%

A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention

Ong,

Ho,

Liow

et al. 2024

Front. Med.

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“…The first nonsurgical treatment to be used can involve steroid therapy, mostly in patients with severe symptoms. Various immunosuppression treatments or surgical treatments may be recommended in patients with more severe symptoms or highly recurrent IGM [10,11]. Antibiotherapy is not recommended if there is no growth in the patient's culture [12,13].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic granulomatous mastitis and steroid use during the pandemic of COVID-19

Çalış

Karabulut

Güler

et al. 2022

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BACKGROUND: Steroid therapy is an immunosuppressive treatment and may have possible side effects in a pandemic period. However, the number of studies on the use corticosteroids for the treatment of idiopathic Granulomatous Mastitis (IGM) especially during the pandemic is almost negligible. METHODS: The data of patients with the diagnosis of IGM between January–December 2020 in the General Surgery Clinic were retrospectively analyzed. The patients were explained in detail that steroid therapy is an immunosuppressive treatment and it may have possible side effects. Prednisolone 0.5–1 mg/kg/day was given as steroid therapy. The treatment was planned for 4–6 months according to the severity of the symptoms and was completed by reducing it to a total dose of 10 mg/month. RESULTS: Eleven patients were included in the study. Five patients had completed steroid treatment and continued their follow-up. In our study, a total of six patients were receiving steroid therapy. CONCLUSIONS: There is no consensus yet on the use of the steroid in the COVID-19 pandemic. Low doses Corticosteroids (<1 mg/kg/day) don’t have an effect on increase mortality in patients with severe COVID-19. We can think that low-dose corticosteroids used by many centers in IGM treatment do not have a negative effect on mortality.

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“…GM is classified as mild when there are a few localized granulomas and severe when there is extensive involvement, leading to significant inflammation, tissue damage, and more pronounced symptoms, including severe breast pain, swelling, skin changes, nipple retraction, and the formation of draining sinuses or abscesses [ 17 , 18 ]. In light of this, studies have reported on various treatments, including topical and oral medications, injections, and surgical interventions.…”

Section: Methodsmentioning

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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Management of Patients with Idiopathic Granulomatous Mastitis: Presentation of 13 Cases

Cited by 6 publications

References 20 publications

A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention

A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention

Idiopathic granulomatous mastitis and steroid use during the pandemic of COVID-19

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

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