Is methotrexate an acceptable treatment in the management of idiopathic granulomatous mastitis?

Akbulut, Sami; Arıkanoğlu, Zülfü; Şenol, Ayhan; Söğütçü, Nilgün; Başbuğ, Murat; Yeniaras, Erhan; Yağmur, Yusuf

doi:10.1007/s00404-010-1825-2

Cited by 84 publications

(74 citation statements)

References 39 publications

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“…The authors recommend a low-dose regimen similar to those recommended for patients suffering from chronic rheumatoid diseases: 7.5-25 mg methotrexate as a weekly dose combined with folic acid applied daily or once a week [36]. The most frequently reported adverse reactions include ulcerative stomatitis, leukopenia, nausea, abdominal distress, undue fatigue, chills and fever, dizziness, and decreased resistance to infection.…”

Section: Resultsmentioning

confidence: 99%

Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge

et al. 2018

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Granulomatous mastitis (GM) is a rare benign inflammatory breast disease that affects mostly women of childbearing age with a history of breastfeeding. The etiopathogenesis is still unknown; however, inflammation as the result of a reaction to trauma, metabolic or hormonal processes, autoimmunity, and an infection with Corynebacterium kroppenstedtii have all been implicated. Clinical findings are pain, mass, hyperemia, and inflammation. Because the clinical presentation can mimic infectious mastitis or inflammatory carcinoma, the disease course is often protracted. The diagnosis is made by histopathology. Biopsies show a granulomatous formation in combination with a localized infiltration of multi-nucleated giant cells, epithelioid histiocytes, and plasma cells. Ultrasound, mammography, and magnetic resonance imaging are not specific; however, ultrasound and mammography should be done to exclude other pathologies. Due to the lack of data including randomized controlled studies, the management of GM is controversial. In Western industrialized countries, most authors use a therapy regimen starting with antibiotics and corticosteroids, followed by continuous steroid therapy and surgery in patients with persisting symptoms. More data are needed to define the best therapy. The role of immunotherapy has not yet been ascertained. The implementation of a registry to collect more information on this rare disease is highly recommended.

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Section: Resultsmentioning

confidence: 99%

Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge

et al. 2018

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“…10,11,14 Currently, surgical management has become less prominent in its management and non-surgical M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 5 recommendations have become more common including medications (i.e., steroids, methotrexate, azathioprine, tuberculosis medications) or close observation. 8,9,15,16 One study found that patients underwent spontaneous resolution in 14.5 months. 9 Since IGM is a non-malignant, non-lifethreatening condition, serious consideration must be made for any treatment, especially those that will be permanently deforming or have potential side effects.…”

Section: Introductionmentioning

confidence: 98%

“…7 There are many reports of mastectomy to treat IGM. 8,9,[10][11][12][13] Recurrence or residual disease, however, may still occur after mastectomy. 10,11,14 Currently, surgical management has become less prominent in its management and non-surgical M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 5 recommendations have become more common including medications (i.e., steroids, methotrexate, azathioprine, tuberculosis medications) or close observation.…”

Section: Introductionmentioning

confidence: 99%

Management of idiopathic granulomatous mastitis with observation

Bouton

Jayaram

O’Neill

et al. 2015

The American Journal of Surgery

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“…Many causative agents have been reported to be linked with the condition like -local irritant, oral contraceptive pill, viruses, mycotic and parasitic infections, hyperprolactinemia, diabetes mellitus, smoking, alfa 1 antitrypsin deficiency, autoimmunity have been proposed to explain the etiology of IGM but never proven. [2][3][4][5][6][7] IGM presents most commonly with a unilateral painful, firm, tender, ill defined mass in the breast 7,8 . The lesions may be located in any quadrant of the breast 7 .…”

Section: Discussionmentioning

confidence: 99%