Ece Bunyamin, Aydin Sonay, Kantarci Mecit
Department of Radiology, Kastamonu University, Kastamonu 37150, Turkey.
Department of Radiology, Erzincan University, Erzincan 24100, Turkey.
J Clin Med. 2023 Mar 15;12(6):2265. doi: 10.3390/jcm12062265.
Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory breast disease treated with local and systemic corticosteroids. This study aims to evaluate the efficacy of reducing corticosteroids doses in IGM cases based on shear wave elastography (SWE) tissue stiffness measurements. This prospective study included IGM patients who received systemic or local corticosteroids between January 2020 and September 2022. A 20% or more reduction in tissue elasticity values (kPa) was considered a positive response to treatment in the study group, and the corticosteroids dose was reduced. The control group was dosed routinely. All patients were followed for 2 years to compare treatment efficacy, duration, total corticosteroids dose, recurrence, and side effects. There were 12 patients (9 local/3 systemic corticosteroids) in the study group and 24 patients (17 local/7 systemic corticosteroids) in the control group. Ten (83.4%) out of 12 patients in the study group were successfully treated by reducing corticosteroid doses with follow-up, and 2 (16.6%) out of 12 patients were reverted to the initial treatment protocol due to an increase in elasticity values during the follow-up. Nevertheless, successful treatment results were obtained in these two patients without reducing the corticosteroid dose. When compared to the control group, the median corticosteroid dose in the study group was significantly lower in patients using both local ( < 0.01) and systemic ( < 0.01) corticosteroids. A significant negative correlation was found between the rate of decrease in elasticity values and the median dose of corticosteroids (r = -0.649, < 0.05) and the median treatment time (r = -0.751, < 0.01). Side effects due to corticosteroids were found to be significantly lower in the study group ( < 0.05). According to our first and preliminary results, the SWE-correlated dose-modifying technique may reduce corticosteroid doses and side effects without significantly compromising treatment efficacy.
特发性肉芽肿性乳腺炎（IGM）是一种采用局部和全身皮质类固醇治疗的慢性炎症性乳腺疾病。本研究旨在基于剪切波弹性成像（SWE）组织硬度测量评估降低IGM病例中皮质类固醇剂量的疗效。这项前瞻性研究纳入了2020年1月至2022年9月期间接受全身或局部皮质类固醇治疗的IGM患者。研究组中组织弹性值（kPa）降低20%或更多被视为对治疗的阳性反应，并降低皮质类固醇剂量。对照组按常规给药。所有患者随访2年以比较治疗效果、持续时间、皮质类固醇总剂量、复发情况和副作用。研究组有12例患者（9例局部/3例全身皮质类固醇），对照组有24例患者（17例局部/7例全身皮质类固醇）。研究组12例患者中有10例（83.4%）通过随访降低皮质类固醇剂量成功治疗，12例患者中有2例（16.6%）因随访期间弹性值增加而恢复至初始治疗方案。然而，这两名患者在未降低皮质类固醇剂量的情况下也获得了成功的治疗结果。与对照组相比，研究组中使用局部（<0.01）和全身（<0.01）皮质类固醇的患者的皮质类固醇中位剂量显著更低。弹性值降低率与皮质类固醇中位剂量（r = -0.649，<0.05）和中位治疗时间（r = -0.751，<0.01）之间存在显著负相关。研究组中皮质类固醇引起的副作用显著更低（<0.05）。根据我们的首次初步结果，SWE相关的剂量调整技术可能会降低皮质类固醇剂量和副作用，而不会显著影响治疗效果。
