The effectiveness of methotrexate and low-dose steroid therapy in the treatment of idiopathic granulomatous mastitis

Dalbaşı, Erkan; Akgül, Ömer Lütfi

doi:10.17219/acem/140842

Cited by 13 publications

(11 citation statements)

References 27 publications

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“…GLM may involve a single breast or both breasts synchronously, although bilateral involvement is rarer, occurring in only 1% of cases ( 9) in one study. In another case series of 62 patients, Dalbaşı et al (41) reported that 30 (48.38%) patients had lesions only in the right breast, 26 (41.94%) patients had lesions only in the left breast, and 6 (9.68%) patients had lesions in both breasts.…”

Section: Localizationmentioning

confidence: 95%

An Update on Granulomatous Lobular Mastitis: It is Time to Tell the Untold

İrkörücü¹

2023

Erciyes Med J

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Objective: Granulomatous mastitis is an infrequent, benign, inflammatory disease of the breast that mostly affects young women of reproductive age. The main objective of this review was to clarify the latest terminology and to provide an update on the diagnosis and management. Materials and Methods:A total of 792 granulomatous mastitis-related articles published in the English literature from 1965 to 2022 were reviewed. Results:The management of this benign but daunting condition remains controversial, and there is no worldwide consensus regarding the best systematic treatment protocol. Good judgment is required to ensure optimal diagnosis and treatment. Conclusion:This narrative review deals with the latest developments in the diagnosis, etiopathogenesis, and modern treatment of the disease.

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Section: Localizationmentioning

confidence: 95%

An Update on Granulomatous Lobular Mastitis: It is Time to Tell the Untold

İrkörücü¹

2023

Erciyes Med J

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“…The recommended dose can be from 7.5 to 25 mg/week, but several studies have suggested that the initial dose is 15 mg/week. The remission rate can be as high as 81-93%, and the average course of treatment is 8-10 months (132,133).…”

Section: Othersmentioning

confidence: 99%

Identification of periductal mastitis and granulomatous lobular mastitis: a literature review

Jiao¹,

Chang²,

Jiang³

et al. 2023

Ann Transl Med

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Background and Objective: Non-puerperal mastitis (NPM) is a breast disease with poor clinical manifestations, which seriously affects women's health and quality of life. Due to the low incidence rate of the disease and the paucity of related research, there is much misdiagnosis and mis-management of periductal mastitis (PDM) and granulomatous lobular mastitis (GLM). Therefore, understanding the differences between PDM and GLM, in terms of etiology and clinical manifestations, is crucial for patient treatment and prognosis. At the same time, choosing different treatment methods may not achieve the best treatment effect, so the appropriate treatment method can often reduce the patient's pain and reduce the recurrence of the patient's disease. Methods:The PubMed database was searched for articles published from 1 January 1990 to 16 June 2022 using the following search terms: "non-puerperal mastitis", "periductal mastitis", "granulomatous lobular mastitis", "mammary duct ectasia", "idiopathic granulomatous mastitis", "plasma cell mastitis", and "identification". The key findings of the related literatures were analyzed and summarized.

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“…There are multiple management modalities of IGM with various advantages and drawbacks, so the treatment of choice is still under debate [6]. The current treatment options are used alone or in combination, including surgical intervention, immunosuppressive agents, steroids, antibiotics, close observation, and herbal treatment like Saussurea Costus (S. costus) which has broad bioactivity against bacterial and mycological infections [7][8][9]. In addition, IGM is associated with a high rate of relapse following treatment, and it requires intensive care and follow-up [10].…”

Section: Introductionmentioning

confidence: 99%

Management of Idiopathic Granulomatous Mastitis: A Single Institution Experience

Esmaeil

Salih

Pshtiwan³

et al. 2023

Breast Care

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Introduction There are multiple management modalities for idiopathic granulomatous mastitis, but the treatment of choice is still under debate. This study aims to evaluate the diagnosis and outcomes of different management modalities in patients with idiopathic granulomatous mastitis and to identify the risk factors associated with recurrence. Method This is a single-group cohort study that included those patients who had idiopathic granulomatous mastitis. Ultrasonography was conducted for all of the cases using LOGIQ E9 with an ML6-15 transducer (5-15 MHz). A core needle biopsy was conducted to take samples from the cases for histopathological examination. The patients were put on steroid therapy. Whenever the cases did not respond to the steroid therapy, treatment with a combination of low-dose steroids and methotrexate was started. In the lack of response to conservative treatments, surgical interventions were started. Results Sixty-three cases with a confirmed histopathological diagnosis of granulomatous mastitis were included. The mean age of patients was 35.7 years. The history of more than one childbirth was positive in a large portion of the cases (82.5%). The lesion side was unilateral in 58.7% of the cases. A large proportion of the lesions were classified as BI-RADS category 2. The best treatment outcome was yielded by a combination of low-dose steroids and incision and drainage. The factors of age, lesion area (cm2), skin thickening, and white blood cell count enhanced the chance of recurrence. Conclusion Incision and drainage in combination with a low dose of steroids can give an acceptable outcome with a low rate of recurrence.

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The effectiveness of methotrexate and low-dose steroid therapy in the treatment of idiopathic granulomatous mastitis

Abstract: Dalbaşı E, Akgül Ö. The effectiveness of methotrexate and low-dose steroid therapy in the treatment of idiopathic granulomatous mastitis [published online as ahead of print on September 9, 2021].

Cited by 13 publications

References 27 publications

An Update on Granulomatous Lobular Mastitis: It is Time to Tell the Untold

An Update on Granulomatous Lobular Mastitis: It is Time to Tell the Untold

Identification of periductal mastitis and granulomatous lobular mastitis: a literature review

Management of Idiopathic Granulomatous Mastitis: A Single Institution Experience

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