학술논문

Treatment modalities for granulomatous mastitis, seeking the most appropriate treatment with the least recurrence rate: a systematic review and meta-analysis
Document Type
Clinical report
Source
European Journal of Medical Research. March 12, 2024, Vol. 29 Issue 1
Subject
United States
Language
English
ISSN
0949-2321
Abstract
Background Granulomatous mastitis (GM) is a rare, benign, inflammatory breast disease with an unknown etiology that predominantly affects women of reproductive age. The definitive treatment of GM is currently controversial; an appropriate therapeutic strategy has yet to be identified, and the disease's high recurrence rate remains. This study aims to determine the recurrence rate for each GM treatment strategy to identify the most appropriate treatment modality. Methods The search for relevant articles was undertaken using three international databases, including Medline, Scopus, and Web of Science. Articles published in English until the end of 2021 evaluating the recurrence rate of GM were included. Using Stata 13.0, the pooled incidence and 95% confidence interval (CI) for the recurrence rate were determined. Results Sixty-five eligible studies were included in our study. The recurrence rates of systemic steroid use, topical steroid use, antibiotic use, methotrexate use, observation, drainage, excision, antibiotic use and surgery, steroid use and surgery, antibiotic and steroid use, methotrexate and steroid use were 24% (95% CI: 21-27%), 11% (95% CI: 6-21%), 18% (95% CI: 14-22%), 13% (95% CI: 7-22%), 11% (95% CI: 7-17%), 65% (95% CI: 50-78%), 13% (95% CI: 10-16%), 23% (95% CI: 14-36%), 7% (95% CI: 5-11%), 11% (95% CI: 6-18%), and 4% (95% CI: 2-8%), respectively. Drainage had the highest recurrence rate, while combined methotrexate and steroid treatment had the lowest rate. Conclusion The optimal treatment strategy for GM depends on the disease's severity, consequences, and the patient's features. The study results indicate that combination therapy is preferable for minimizing the risk of relapse and reducing treatment complications. Keywords: Granulomatous mastitis, Recurrence, Therapeutic modalities, Surgery, Conservative treatment, Observation, Combination therapy, Granulomatous lobular mastitis
Author(s): Roham Sarmadian[sup.1], Fatemeh Safi[sup.2], Hossein Sarmadian[sup.3], Maryam Shokrpour[sup.4] and Amir Almasi-Hashiani[sup.5,6] Backgrounds Granulomatous mastitis (GM) is an uncommon, benign, inflammatory breast disease with an unknown etiology that mainly affects [...]