Role of Corticosteroids along with Other Therapies for Treatment of Idiopathic Granulomatous Mastitis: A Narrative Review Corticosteroids in IGM
Abstract
Background: The use of oral corticosteroids to treat idiopathic granulomatous mastitis (IGM) has been a point of controversy for a long time. In addition, a wide diversity of combinations with other therapies have been reported so far. This study aims to review the usage of oral corticosteroids and their combinations in the published literature.
Methods: PubMed and Scopus were searched using the key word “granulomatous mastitis.” Citations were filtered in two stages, considering the titles/abstracts and full texts. Papers reporting the treatment of IGM with corticosteroids with/without other treatments were included.
Results: Fifty-eight citations were included in this study, 31 of which had at least a group of patients treated only with systemic corticosteroids. Combination therapy of systemic steroids with immunosuppressants, surgical interventions, and antibiotics were used in 6, 12, and 13 studies, respectively.
Conclusion: Considering the inconsistency of studies in reporting the severity of the disease, administered treatments, outcome of treatment, side effects, and follow-up, our study failed to provide solid evidence for using corticosteroids as the first step in the management of idiopathic granulomatous mastitis. There is still a need for further studies emphasizing the homogenization of such reports. In this regard, preparing a questionnaire to help homogenize future reports on IGM is highly recommended.
References
Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol. 1972;58(6):642-6. doi: 10.1093/ajcp/58.6.642.
Martinez-Ramos D, Simon-Monterde L, Suelves-Piqueres C, Queralt-Martin R, Granel-Villach L, Laguna-Sastre JM, et al. Idiopathic granulomatous mastitis: A systematic review of 3060 patients. Breast J. 2019;25(6):1245-50. doi: 10.1111/tbj.13446.
Metanat S, Jobaneh YS, Noori M, Sadeghi F, Mirzapour A, Mashoori N, et al. Global Distribution of Idiopathic Granulomatous Mastitis: A Scoping Review: IGM Global Distribution. Archives of Breast Cancer. 2022;9(special Issue).
Azlina AF, Ariza Z, Arni T, Hisham AN. Chronic granulomatous mastitis: diagnostic and therapeutic considerations. World journal of surgery. 2003;27(5):515-8. doi:10.1007/S00268-003-6806-1
Tamura Y. Granulomatous Mastitis with Corynebacterium Infection: IGM with Corynebacterium. Archives of Breast Cancer. 2022;9(special Issue).
Lei X, Chen K, Zhu L, Song E, Su F, Li S. Treatments for Idiopathic Granulomatous Mastitis: Systematic Review and Meta-Analysis. Breastfeed Med. 2017;12(7):415-21. doi: 10.1089/bfm.2017.0030.
Gunduz Y, Altintoprak F, Tatli Ayhan L, Kivilcim T, Celebi F. Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation. The breast journal. 2014;20(6):586-91. doi: 10.1111/TBJ.12335.
Tekgöz E, Çolak S, Çinar M, Yilmaz S. Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence. Turkish Journal of Medical Sciences. 2020;50(5):1380-. doi: 10.3906/SAG-2003-93.
Karanlik H, Ozgur I, Simsek S, Fathalizadeh A, Tukenmez M, Sahin D, et al. Can Steroids plus Surgery Become a First-Line Treatment of Idiopathic Granulomatous Mastitis? Breast care (Basel, Switzerland). 2014;9(5):338-42. doi: 10.1159/000366437.
Pandey TS, MacKinnon JC, Bressler L, Millar A, Marcus EE, Ganschow PS. Idiopathic granulomatous mastitis--a prospective study of 49 women and treatment outcomes with steroid therapy. The breast journal. 2014;20(3):258-66. doi: 10.1111/TBJ.12263.
Curtis JR, Westfall AO, Allison J, Bijlsma JW, Freeman A, George V, et al. Population-based assessment of adverse events associated with long-term glucocorticoid use. Arthritis Rheum. 2006;55(3):420-6. doi: 10.1002/art.21984.
Waljee AK, Rogers MA, Lin P, Singal AG, Stein JD, Marks RM, et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. Bmj. 2017;357:j1415. doi: 10.1136/bmj.j1415.
Aghajanzadeh M, Hassanzadeh R, Alizadeh Sefat S, Alavi A, Hemmati H, Esmaeili Delshad MS, et al. Granulomatous mastitis: Presentations, diagnosis, treatment and outcome in 206 patients from the north of Iran. Breast (Edinburgh, Scotland). 2015;24(4):456-60. doi: 10.1016/J.BREAST.2015.04.003.
Akcan A, Öz AB, Dogan S, Akgün H, Akyüz M, Ok E, et al. Idiopathic Granulomatous Mastitis: Comparison of Wide Local Excision with or without Corticosteroid Therapy. Breast care (Basel, Switzerland). 2014;9(2):111-5. doi: 10.1159/000360926.
Akin M, Karabacak H, Esendağli G, Yavuz A, Gültekin S, Dikmen K, et al. Coexistence of idiopathic granulomatous mastitis and erythemanodosum: successful treatment with corticosteroids. Turkish journal of medical sciences. 2017;47(5):1590-2. doi: 10.3906/SAG-1611-100.
Altintoprak F. Topical steroids to treat granulomatous mastitis: a case report. The Korean journal of internal medicine. 2011;26(3):356-9. doi: 10.3904/KJIM.2011.26.3.356
Alungal J, Abdulla MC, Narayan R. Idiopathic granulomatous mastitis with erythema nodosum and polyarthritis. Reumatismo. 2016;68(2):97-9. doi: 10.4081/REUMATISMO.2016.844.
Atak T, Sagiroglu J, Eren T, Özemir IA, Alimoglu O. Strategies to treat idiopathic granulomatous mastitis: retrospective analysis of 40 patients. Breast disease. 2015;35(1):19-24. doi: 10.3233/BD-140373.
Berkesoglu M, Dag A, Tuncel F, Ustun RO. Management of Granulomatous Mastitis Following Aesthetic Breast Surgery. Aesthetic plastic surgery. 2021;45(3):875-81. doi: 10.1007/S00266-020-01992-9.
Binesh F, Shiryazdi M, Owlia MB, Azimi S. Idiopathic granulomatous mastitis, erythema nodosum and bilateral ankle arthritis in an Iranian woman. BMJ case reports. 2013;2013. doi: 10.1136/BCR-2012-007636.
Boufettal H, Essodegui F, Noun M, Hermas S, Samouh N. Idiopathic granulomatous mastitis: a report of twenty cases. Diagnostic and interventional imaging. 2012;93(7-8):586-96. doi: 10.1016/J.DIII.2012.04.028.
Ciftci F, Abdurrahman I, Tatar Z. The effect of corticosteroid treatment on bilateral idiopathic granulomatous mastitis. Turkish journal of surgery. 2015;33(2):113-5. doi: 10.5152/UCD.2015.2950.
Co M, Cheng VCC, Wei J, Wong SCY, Chan SMS, Shek T, et al. Idiopathic granulomatous mastitis: a 10-year study from a multicentre clinical database. Pathology. 2018;50(7):742-7. doi: 10.1016/J.PATHOL.2018.08.010.
Deng JQ, Yu L, Yang Y, Feng XJ, Sun J, Liu J, et al. Steroids administered after vacuum-assisted biopsy in the management of idiopathic granulomatous mastitis. Journal of clinical pathology. 2017;70(10):827-31. doi: 10.1136/JCLINPATH-2016-204287.
Erozgen F, Ersoy YE, Akaydin M, Memmi N, Celik AS, Celebi F, et al. Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast cancer research and treatment. 2010;123(2):447-52. doi: 10.1007/S10549-010-1041-6.
Goldberg J, Baute L, Storey L, Park P. Granulomatous mastitis in pregnancy. Obstetrics and gynecology. 2000;96(5 Pt 2):813-5. doi: 10.1016/S0029-7844(00)01051-6.
Gopalakrishnan Nair C, Hiran, Jacob P, Menon RR, Misha. Inflammatory diseases of the non-lactating female breasts. International journal of surgery (London, England). 2015;13:8-11. doi: 10.1016/J.IJSU.2014.11.022.
Goulabchand R, Perrochia H, Aubert-Bringer E, Do Trinh P, Guilpain P. Idiopathic granulomatous mastitis responding to oral prednisone. The breast journal. 2020;26(2):281-3. doi: 10.1111/TBJ.13552.
Gümüş M, Akkurt ZM, Gümüş H. Is erythema nodosum coexisting with lesions of the breast a suggestive sign for idiopathic granulomatous mastitis? Turkish journal of surgery. 2018;34(1):71-3. doi: 10.5152/TURKJSURG.2017.3161.
Gupta N, Vats M, Garg M, Dahiya DS. Bilateral idiopathic granulomatous mastitis. BMJ case reports. 2020;13(8). doi: 10.1136/BCR-2020-234979.
Gurleyik G, Aktekin A, Aker F, Karagulle H, Saglam A. Medical and surgical treatment of idiopathic granulomatous lobular mastitis: a benign inflammatory disease mimicking invasive carcinoma. Journal of breast cancer. 2012;15(1):119-23. doi: 10.4048/JBC.2012.15.1.119.
Hashmi D, Al Samaraee A, Marks B, Fasih T. Idiopathic granulomatous mastitis: a diagnostic dilemma. Br J Hosp Med (Lond). 2020 Feb 2;81(2):1-4. doi: 10.12968/hmed.2019.0287.
Hirata S, Saito T, Kiyanagi K, Kitada M, Yamazaki K, Sasajima T, et al. Granulomatous mastitis diagnosed by core-needle biopsy and successfully treated with corticosteroid therapy: a case report. Breast cancer (Tokyo, Japan). 2003;10(4):378-81. doi: 10.1007/BF02967662.
Hwang MJ, Rogers A, Vidya R. Idiopathic granulomatous mastitis: rare but important. BMJ case reports. 2010;2010. doi: 10.1136/BCR.10.2009.2334.
Jayia P, Oberg E, Tuffaha H, Leff DR, Al-Mufti R, Hadjiminas D. Should we manage all cases of granulomatous mastitis conservatively? A 14 year experience. The breast journal. 2013;19(2):215-6. doi: 10.1111/TBJ.12087.
Jorgensen MB, Nielsen DM. Diagnosis and treatment of granulomatous mastitis. The American Journal of Medicine. 1992;93(1):97-101. doi: 10.1016/0002-9343(92)90688-8.
Kalaycı TÖ, Bedel Koruyucu M, Apaydın M, Etit D, Varer M. Idiopathic Granulomatous Mastitis Associated with Erythema Nodosum. Balkan Medical Journal. 2016;33(2):228-. doi: 10.5152/BALKANMEDJ.2015.150089.
Konan A, Kalyoncu U, Dogan I, Kiliç YA, Karakoç D, Akdogan A, et al. Combined long-term steroid and immunosuppressive treatment regimen in granulomatous mastitis. Breast care (Basel, Switzerland). 2012;7(4):297-301. doi: 10.1159/000341388.
Maffini F, Baldini F, Bassi F, Luini A, Viale G. Systemic therapy as a first choice treatment for idiopathic granulomatous mastitis. Journal of cutaneous pathology. 2009;36(6):689-91. doi: 10.1111/J.1600-0560.2008.01102.X.
Mahmodlou R, Dadkhah N, Abbasi F, Nasiri J, Valizadeh R. Idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment. Electronic physician. 2017;9(9):5375-9. doi: 10.19082/5375.
Miliauskas JR, Pieterse AS, Williams RS. Granulomatous lobular mastitis. The Australian and New Zealand journal of surgery. 1995;65(2):139-41. doi: 10.1111/J.1445-2197.1995.TB07281.X.
Montazer M, Dadashzadeh M, Toomatari SEM. Comparison of the Outcome of Low Dose and High-Dose Corticosteroid in the Treatment of Idiopathic Granulomatous Mastitis. Asian Pacific Journal of Cancer Prevention: APJCP. 2020;21(4):993-. doi: 10.31557/APJCP.2020.21.4.993.
Mote DG, Gungi RP, Satyanarayana V, Premsunder T. Granulomatous mastitis - a diagnostic dilemma. The Indian journal of surgery. 2008;70(5):241-3. doi: 10.1007/S12262-008-0069-X.
Nakamura T, Yoshioka K, Miyashita T, Ikeda K, Ogawa Y, Inoue T, et al. Granulomatous mastitis complicated by arthralgia and erythema nodosum successfully treated with prednisolone and methotrexate. Internal medicine (Tokyo, Japan). 2012;51(20):2957-60. doi: 10.2169/INTERNALMEDICINE.51.7846.
Naraynsingh V, Hariharan S, Dan D, Harnarayan P, Teelucksingh S. Conservative management for idiopathic granulomatous mastitis mimicking carcinoma: case reports and literature review. Breast disease. 2010;31(1):57-60. doi: 10.3233/BD-2009-0294.
Ocal K, Dag A, Turkmenoglu O, Kara T, Seyit H, Konca K. Granulomatous Mastitis: Clinical, Pathological Features, and Management. The Breast Journal. 2010;16(2):176-82. doi: 10.1111/J.1524-4741.2009.00879.X.
Omranipour R, Mohammadi SF, Samimi P. Idiopathic granulomatous lobular mastitis - report of 43 cases from iran; introducing a preliminary clinical practice guideline. Breast care (Basel, Switzerland). 2013;8(6):439-43. doi: 10.1159/000357320.
Oran EŞ, Gürdal SÖ, Yankol Y, Öznur M, Calay Z, Tunaci M, et al. Management of idiopathic granulomatous mastitis diagnosed by core biopsy: a retrospective multicenter study. The breast journal. 2013;19(4):411-8. doi: 10.1111/TBJ.12123.
Patel RA, Strickland P, Sankara IR, Pinkston G, Many W, Rodriguez M. Idiopathic granulomatous mastitis: case reports and review of literature. Journal of general internal medicine. 2010;25(3):270-3. doi: 10.1007/S11606-009-1207-2.
Raj N, MacMillan RD, Ellis IO, Deighton CM. Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology. 2004;43(8):1055-6. doi: 010.1093/RHEUMATOLOGY/KEH246.
Ringsted S, Friedman M. A Rheumatologic Approach to Granulomatous Mastitis: a Case Series and Systematic Review. International journal of rheumatic diseases. 2021;24(4):526-. doi: 10.1111/1756-185X.14065.
Ruiter AM, Vegting IL, Nanayakkara PWB. Idiopathic granulomatous mastitis: a great imitator? BMJ case reports. 2010;2010. doi: 10.1136/BCR.03.2010.2844.
Sakurai K, Fujisaki S, Enomoto K, Amano S, Sugitani M. Evaluation of follow-up strategies for corticosteroid therapy of idiopathic granulomatous mastitis. Surgery today. 2011;41(3):333-7. doi: 10.1007/S00595-009-4292-2.
Salehi M, Salehi H, Moafi M, Taleban R, Tabatabaei SA, Salehi M, et al. Comparison of the effect of surgical and medical therapy for the treatment of idiopathic granulomatous mastitis. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences. 2014;19(Suppl 1):S5-S.
Salehi M, Salehi M, Kalbasi N, Hakamifard A, Salehi H, Salehi M, et al. Corticosteroid and Azithromycin in Idiopathic Granulomatous Mastitis. Advanced biomedical research. 2017;6(1):8-. doi: 10.4103/2277-9175.199259.
Sato N, Yamashita H, Kozaki N, Watanabe Y, Ohtsuka T, Kuroki S, et al. Granulomatous mastitis diagnosed and followed up by fine-needle aspiration cytology, and successfully treated by corticosteroid therapy: report of a case. Surgery today. 1996;26(9):730-3. doi: 10.1007/BF00312095.
Sheybani F, Sarvghad MR, Naderi HR, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis. Obstetrics and gynecology. 2015;125(4):801-7. doi: 10.1097/AOG.0000000000000734.
Shojaee L, Rahmani N, Moradi S, Motamedi A, Godazandeh G. Idiopathic granulomatous mastitis: challenges of treatment in iranian women. BMC surgery. 2021;21(1):206-. doi: 10.1186/S12893-021-01210-6.
Su FH, Liu SC, Suen JH, Chen DS, Sister Mary Ann Lou. Idiopathic granulomatous mastitis: a case successfully treated with a minimum dose of a steroid. Chang Gung Med J. 2005 Jun;28(6):431-5.
Tuli R, O'Hara BJ, Hines J, Rosenberg AL. Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: a case report and review of the literature. International Seminars in Surgical Oncology. 2007;4:21-. doi: 10.1186/1477-7800-4-21.
Velidedeoglu M, Kilic F, Mete B, Yemisen M, Celik V, Gazioglu E, et al. Bilateral idiopathic granulomatous mastitis. Asian journal of surgery. 2016;39(1):12-20. doi: 10.1016/J.ASJSUR.2015.02.003.
Yabanoʇlu H, Çolakoʇlu T, Belli S, Aytac HO, Bolat FA, Pourbagher A, et al. A Comparative Study of Conservative versus Surgical Treatment Protocols for 77 Patients with Idiopathic Granulomatous Mastitis. The breast journal. 2015;21(4):363-9. doi: 10.1111/TBJ.12415.
Yaghan RJ, Ayoub NM, Hamouri S, Al-Mohtaseb A, Gharaibeh M, Yaghan L, et al. The Role of Establishing a Multidisciplinary Team for Idiopathic Granulomatous Mastitis in Improving Patient Outcomes and Spreading Awareness about Recent Disease Trends. International Journal of Breast Cancer. 2020;2020. doi: 10.1155/2020/5243958.
Yu H, Wang Q. Severe idiopathic granulomatous mastitis treated with systemic medication; A case report. The Journal of International Medical Research. 2020;48(1). doi:10.1177/0300060519895685.
Godazandeh G, Shojaee L, Alizadeh-Navaei R, Hessami A. Corticosteroids in idiopathic granulomatous mastitis: a systematic review and meta-analysis. Surgery Today. 2021:1-9. doi: 10.1007/s00595-021-02234-4.
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