The effectiveness of local steroid injection for the treatment of breast-limited idiopathic granulomatous mastitis: A randomized controlled clinical trial study

Abstract

Background: Idiopathic granulomatous mastitis (IGM) is a rare non-specific inflammatory breast disease and is usually considered a kind of autoimmune disease. There are several controversies regarding its standard treatment. We aimed to evaluate the efficacy of local corticosteroid injection for the treatment of breast-limited idiopathic granulomatous mastitis.Methods: This randomized prospective clinical trial study evaluated the clinical response rate of local steroid injection to treat breast-limited IGM in women. The subjects received local steroid injection of long-action (LA) Betamethasone combined with standard systemic treatments (prednisolone, Methotrexate) (Combine therapy group), standard systemic treatments alone (Systemic group), or local steroid injection alone (LA Betamethasone, Injection group). Clinical benefits and recurrence rates were compared in the three groups.Results: All of the patients were women, and their mean age was 34 years. The excellent clinical or radiological response was observed in 20/31 (64.5%), 24/38 (63.1%), and 17/30 (56.6 %) patients in the injection, combined, and systemic therapy groups, respectively. During the follow-up of 10 months in patients who received local steroid injection alone, recurrence was observed in six patients (16.4%, 6/31), and no side effects or injection steroid-related complications occurred. The local recurrence rate in systemic and combined therapy groups were 3.3 % (1/30) and 13.2 % (5/38) patients, respectively.Conclusions: Our findings suggest that local betamethasone LA injection in breast limited IGM is as successful as current standard treatment and shortens the complete healing time compared to treatment with systemic therapy. Short time recurrence rate was not statistically significant among the groups. Local injection could be a beneficial option in the treatment of IGM. Trial registration: The trial registry number was IRCT20200608047694N1. Registration date: 2020-07-21.

Management of Lobular Granulomatous Mastitis; Special Focus on Treatment Challenges in Patients with Hyperprolactinemia, Erythema Nodosum, and Diabetes, and Factors Associated with a Persistent Disease Course

“…A study involving 156 patients who received 5 days of in-patient steroid therapy before excisional surgery revealed that only 5.1% of them experienced recurrence, a signi cantly lower rate compared to those who solely received prednisone (p < 0.01) (18). In addition to systemic steroid administration, the utilization of topical steroid application and intralesional injections has also shown promising results (19,20).…”

Shear Wave Elastography-Correlated Dose Modifying: Can We Reduce Corticosteroid Doses in Idiopathic Granulomatous Mastitis Treatment? Preliminary Results

“…The administration of corticosteroids prior to surgery for large lesions improves the aesthetic outcome. Intralesional corticosteroid injection and topical corticosteroid can be used to treat IGM patients with primarily skin changes or who have experienced systemic corticosteroid side effects [ 11 , 14 ]. The principal drawback of corticosteroid therapy is its side effects, which manifest themselves primarily after long-term, high-dose use.…”