Methotrexate in the management of granulomatous mastitis

Abstract

Granulomatous mastitis is a rare benign inflammatory breast disease that often clinically simulates carcinoma. Surgical resection of the entire lesion has been the main method of treatment but recurrence, infection, sinus formation and delayed wound healing can occur relatively commonly. Corticosteroids are also effective in recurrent or resistant cases but are associated with side-effects and relapse of disease after steroid withdrawal. A low weekly oral dose of methotrexate was used in five resistant cases after surgery plus corticosteroid. All cases achieved remission, withdrawal of corticosteroid without relapse and no methotrexate side-effect.

İdiopatik granulomatöz mastit: Zor tanı ve yönetim

“…Kim ve ark. 17 diğer tedavilere dirençli olgularda, klinik cevap sınırlı olsa bile, metotreksat veya azotioprin gibi immünosupressif ajanların kullanılabileceğini; Asoğlu ve ark. 18 ise medikal tedaviye cevapsızlık ve tekrarlayan abse veya fistül gibi klinik bulgular varlığında, geniş lokal eksizyon veya gerekirse mastektominin bile uygulanabileceğini bildirmişlerdir.…”

Idiopathic granulomatous mastitis: a great diagnostic challenge

“…They may be used preoperatively as well as postoperatively [6]. But steroids have got multiple side effects on long term usage and hence other immunosuppressive drugs like methotrexate and azathioprine have been used in low doses mainly as steroid sparing agents to maintain remission [7]. Surgery is useful both for diagnosis as well as treatment particularly when there is suboptimal response to medical treatment.…”

Vacuum-assisted biopsy and steroid therapy for granulomatous lobular mastitis: Report of three cases

“…[1][2][3][4][5][6][7][8] These patients ranged in age from 11 to 80 years (mean, 35 years) and 96% (174/181) were multiparous women. The cause of GLM is unknown, but it could be related to age and pregnancy.…”

“…However, the disease is occasionally confused with malignancy, with reports of mastectomy or chemotherapy being performed. [1][2][3][4][5][6][7] Therefore, thorough tissue examination is a prerequisite for the differential diagnosis of GLM. Cincinnati, OH, USA), a relatively non-invasive and safe procedure, has become popular in the last decade.…”