Comment on: “Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence”

Abstract

We read the recent article "Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence" published by Tekgoz and colleagues with great interest [1]. The authors stated that they aimed to investigate the effect of immunosuppressive treatment on idiopathic granulomatous mastitis (IGM) and risk factors related to IGM recurrence.We would like to emphasize a few important points regarding the medical management algorithm of the present study.The authors state that they have applied a cross-sectional retrospective research model in the present study. This statement is wrong in terms of epidemiological aspect because the studies that go from the outcome to the exposure are retrospective case-control studies. The cross-sectional studies evaluate the exposure and outcome at the same time and are usually performed to determine the prevalence of certain conditions or diseases. Other names of the study method are epidemiological surveillance, transvers study, screening, fact-findings survey, ad hoc survey, point-in-time study, and one-shot survey.The authors did not give any information regarding their management protocol to patients with IGM. In Turkey, the duration from admission to the histopathological diagnosis of IGM is around 3-4 weeks. In patients with abscess and cellulitis, it is not rational to wait for the biopsy result without performing drainage and/or antibiotics. The current literature suggests that drainage and antibiotics should be performed to patients admitted with abscess and cellulitis. Also, patients with inflammatory mass should receive antiinflammatory treatment after the biopsy until the definitive results are obtained. We would like to share our diagnostic and therapeutic algorithm that we have deduced from our own experiences and extensive review of the literature (Figure). We believe it will contribute to the present study and this extensive algorithm is first in the medical literature.

Idiopathic granulomatous mastitis and steroid use during the pandemic of COVID-19

“…Therefore, one of the radical surgical treatment options (partial or total mastectomy-plus breast reconstruction) should be offered to reproductive agedpatients who have recurred IGM disease despite more than 2 cycles of steroid and MTX treatment. Since it is necessary to inform the patients correctly about the side effects of long-term immunosuppressive treatment protocols [15].…”