Surgical Oncology Unit, Institute of Oncology, Istanbul University, Turkey.
Ercis State Hospital, Van, Turkey.
Breast Care (Basel). 2014 Oct;9(5):338-42. doi: 10.1159/000366437.
The aim of this study is to compare the clinical course of idiopathic granulomatous mastitis (IGM) treated with low-dose oral corticosteroid therapy alone as opposed to treatment with low-dose corticosteroid therapy followed by surgery.
37 patients were treated with an approach that consisted of methylprednisolone at a dose of 0.5 mg/kg/day followed by wide excision, and 23 patients were treated with an approach that consisted only of methylprednisolone. The treatment efficacy was compared between the two groups.
Clinical and radiological regression was reported in all patients with steroid therapy, and the regression rate had a median of 75% (25-100%). No recurrence was observed in patients who were treated with wide surgical excision after steroid therapy during the median follow-up period of 38 (22-78) months. The control group of 23 patients was treated only with steroid therapy, and 7 (30%) of these patients experienced recurrence in the follow-up period (p < 0.001).
Steroid therapy was effective in the treatment of IGM by reducing the lesion size and extent. With regard to the current treatment options available for IGM, surgical excision after steroid therapy seems the better treatment option compared to steroid therapy without surgical excision. This treatment sequence reduces the rate of recurrence.
本研究旨在比较单独使用低剂量口服皮质类固醇治疗与低剂量皮质类固醇治疗后手术治疗特发性肉芽肿性乳腺炎（IGM）的临床过程。
37 例患者采用甲泼尼龙 0.5mg/kg/天剂量治疗，然后行广泛切除术，23 例患者仅采用甲泼尼龙治疗。比较两组的治疗效果。
所有接受类固醇治疗的患者均出现临床和影像学消退，消退率中位数为 75%（25%-100%）。在类固醇治疗后中位随访 38（22-78）个月期间，接受广泛手术切除的患者无复发。对照组 23 例患者仅接受类固醇治疗，其中 7 例（30%）在随访期间复发（p<0.001）。
类固醇治疗通过缩小病变大小和范围对 IGM 有效。对于 IGM 目前可用的治疗选择，类固醇治疗后手术切除似乎比不切除的类固醇治疗更好，这种治疗顺序降低了复发率。
