Evaluation of the Effect of Prednisolone in Treatment Patients with Idiopathic Granulomatous Mastitis

Abstract

Introduction: Inflammatory lesions of the breast granulomatosis can be considered as primary or idiopathic inflammation of the breast or as a secondary complication of a wide range of diseases and conditions such as tuberculosis and other external diseases, especially infections, especially infections. The initial manifestation of these diseases in the form of mastitis is very rare, with secondary causes of high idiopathic granulomatous mastitis. The aim of this study was to evaluate the effect of prednisolone in the treatment of patients with idiopathic granulomatous mastitis referred to Urmia Imam Khomeini Hospital from 2018 to 2020.
Materials and Methods: In this cross-sectional-analytical study, all patients who were referred to Imam Khomeini Hospital by a surgeon with a diagnosis of idiopathic granulomatous mastitis during the year 2017 to 2018 (50 patients) were included in this study. Parasites and foreign bodies, granulomastitis mastitis, were excluded. Patients were first treated with 60 mg prednisolone for 2 weeks and then received 40 mg prednisolone for 8 weeks and this dose was reduced over 6 months. The patients were evaluated during 1 month, 3 months, 6 months and one year after the start of treatment and all the information required for the study including age, location of lesion, clinical manifestations, mean time of treatment and recurrence in the researcher-made checklists was entered and then analyzed after data collection.
Results: The mean age of patients was 33.3 ± 8.2 years, with a minimum age of 19 years and a maximum age of 51 years. 36% of clinical manifestations were in the form of mass, 20% in the form of breast abscess, 4% in breast swelling and 20% in simultaneous breast swelling, pain, discharge and breast abscess. 58% of patients took birth control pills, with a mean duration of use of birth control pills (20.4 ± 39) per month. 100% of patients have received corticosteroids. 36% of patients with idiopathic granulomatous mastitis have not recovered and 64% of them have received complete treatment and recovery. out of 32 patients, 2 (6.2%) after one month of drug use, 5 (15.6%) 3 months after drug use and 15 (46.9%) after 6 months of drug use and 10 patients (31.3%) recovered after one year of drug use. 18 patients did not recover, of which 10 patients (55.5%) did not respond to treatment due to recurrence despite drug use and 8 patients (44.5%) did not respond to treatment due to drug discontinuation; 5 patients (27.8%) discontinued the drug due to drug side effects and 3 patients (16.7%) discontinued the drug arbitrarily.
Conclusion: According to the study, it can be concluded that corticosteroids in the treatment of granulomatous mastitis can be considered as the first line. It seems that high-dose corticosteroids are much more effective than other doses and the recurrence rate and duration of treatment in this type of treatment is less than other treatments.