Yıl: 2021 Cilt: 17 Sayı: 3 Sayfa Aralığı: 283 - 287 Metin Dili: İngilizce DOI: 10.4274/ejbh.galenos.2021.2021-2-4 İndeks Tarihi: 12-11-2021

Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis

Öz:
Objective: Idiopathic granulomatous mastitis (IGM) is an inflammatory and chronic benign breast disease that has proven difficult to diagnose and treat. Since most treatment modalities cannot be used in pregnant patients, the choice of treatment is more difficult and the need for surgery is more pressing. In this first and innovative study, we assess the results of local corticosteroid therapy of IGM in pregnant women.Materials and Methods: Pregnant women with IGM were evaluated between June 2017 and May 2019. The six pregnant women were treated using intralesional steroid injections and topical steroid administration. The treatment response was evaluated, both clinically and radiologically, at the end of 2 weeks and once more at the end of 1 month.Results: The median patient age was 26 years. The mean duration of complaints was 4.3 months. The median number of children was 2, and the mean breastfeeding time was 41 months. The predominant complaints at onset were a breast mass or local pain and inflammation in four (66.7%) patients and a breast mass with pain and without signs of local skin inflammation in two (33.3%) patients. Diagnosis was made using a tru-cut biopsy in two patients, and with an incisional biopsy in four patients who had abscess drainage and fistulation to the skin. Five (83.3%) patients achieved a complete response, and one (16.7%) patient responded only partially after the first course of treatment. A second course of treatment was given to the patient with partial response. All patients achieved complete response at the end of the second course of treatment. The mean follow-up time was 19.5 months. During the follow-up period, one patient experienced a recurrence at 4 months after giving birth, and she then received a third course of treatment. Topical and systemic side effects of the corticosteroids were not observed in any patient.Conclusion: While the state of pregnancy generally precludes the use of most drugs, the use of local corticosteroid in the treatment of IGM is effective in terms of treatment response, treatment duration, need for surgery, and reduced recurrence and side effects.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık
  • 1. Toktas O, Konca C, Trabulus DC. Soyder A, Koksal H, Karanlik H. et al. A novel first-line treatment alternative for noncomplicated idiopathic granulomatous mastitis: combined intralesional steroid injection with topical steroid administration. Breast Care 2021; 16: 181-187. [Crossref]
  • 2. Garcia-Rodiguez JA, Pattullo A. Idiopathic granulomatous mastitis: a mimicking disease in a pregnant woman: a case report. BMC Research Notes 2013; 6: 95. (PMID: 23497626) [Crossref]
  • 3. Ocal K, Dag A, Turkmenoglu O, Kara T, Seyit H, Konca K. Granulomatous mastitis: clinical, pathological features, and management. Breast J 2010; 16: 176-182. (PMID: 20030652) [Crossref]
  • 4. Gunduz Y, Altintoprak F, Ayhan TL, Kivilcim T, Celebi F. Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation. Breast J 2014; 20: 586-591. (PMID: 25228089) [Crossref]
  • 5. Alper F, Karadeniz E, Guven F, Cenkaya BY, Ozden K, Akcay MN. The evaluation of the efficacy of local steroid administration in idiopathic granulomatous mastitis: The preliminary results. Breast J 2020; 26: 309- 311. (PMID: 31495032) [Crossref]
  • 6. Mizrakli T, Velidedeoglu M, Yemisen M, Mete B, Kilic F, Yilmaz H. et al. Corticosteroid treatment in the management of idiopathic granulomatous mastitis to avoid unnecessary surgery. Surg Today 2015; 45: 457‐465. (PMID: 24993812) [Crossref]
  • 7. Bani-Hani KE, Yaghan RJ, Matalka I, Shatnawi NJ. Idiopathic granulomatous mastitis: time to avoid unnecessary mastectomies. Breast J 2004; 10: 318-322. (PMID: 15239790) [Crossref]
  • 8. Cetin K, Sikar HE, Goret NE, Rona G, Barisik ON, Kucuk HF. et al. Comparison of topical, systemic, and combined therapy with steroids on idiopathic granulomatous mastitis: a prospective randomized study. World J Surg 2019; 43: 2865-2873. (PMID: 31297582) [Crossref]
  • 9. Barreto DS, Sedgwick EL, Nagi CS, Benveniste AP. Granulomatous mastitis: etiology, imaging, pathology, treatment, and clinical findings. Breast Cancer Res Treat 2018; 171: 527-534. (PMID: 29971624) [Crossref]
  • 10. Lei X, Chen K, Zhu L, Song E, Su F, Li S. Treatment for idiopathic granulomatous mastitis: systemic review and meta-analysis. Breastfeed Med 2017; 12: 415-421. (PMID: 28731822) [Crossref]
  • 11. Goldberg J, Baute L, Storey L, Park P. Granulomatous mastitis in pregnancy. Obstet Gynecol 2000; 96: 813-815. (PMID: 11094217) [Crossref]
  • 12. Destek S, Gul OV. Idiopathic granulomatous mastitis: a disease mimics breast cancer appearing in pregnancy. Gen Surg: Open Access 2018; 1: 7-10. [Crossref]
  • 13. Yabanoglu H, Colakoglu T, Belli S, Aytac HO, Bolat FA, Pourbager A. et al. A comparative study of conservative versus surgical treatment protocols for 77 patients with idiopathic granulomatous mastitis. Breast J 2015; 21: 363-369. (PMID: 25858348) [Crossref]
  • 14. Skandarajah A, Marley L. Idiopathic granulomatous mastitis: a medical or surgical disease of the breast? ANZ J Surg 2015; 85: 979-982. (PMID: 25424519) [Crossref]
  • 15. Palmsten K, Rolland M, Hebert MF, Clowse MEB, Schatz M, Xu R. et al. Patterns of prednisone use during pregnancy in women with rheumatoid arthritis: Daily and cumulative dose. Pharmacoepidemiol Drug Saf 2018; 27: 430-438. (PMID: 29488292) [Crossref]
  • 16. Empson MB, Lassere M, Craig JC, Scott JR. Prevention of recurrent miscarriage for women with antiphospholipid antibody or lupus anticoagulant. Cochrane Database Syst Rev 2005; 2005: CD002859. doi: 10.1002/14651858.CD002859.pub2 (PMID: 15846641) [Crossref]
  • 17. Altintoprak F, Kivilcim T, Yalkin O, Uzunoglu Y, Kahyaoglu Z, Dilek ON. Topical steroids are effective in the treatment of idiopathic granulomatous Mastitis. World J Surg 2015; 39: 2718-2723. (PMID: 26148520) [Crossref]
  • 18. Altintoprak, F, Kivilcim T, Ozkan OV. Aetiology of idiopathic granulomatous mastitis. World J Clin Cases 2014; 2: 852-858. (PMID: 25516860) [Crossref]
  • 19. Karanlik H, Ozgur I, Simsek S, Fathalizadeh A, Tukenmez M, Sahin D. et al. Can steroids plus surgery become a first-line treatment of idiopathic granulomatous mastitis? Breast Care (Basel) 2014; 9: 338-342. (PMID: 25759614) [Crossref]
  • 20. Goulabchand R, Perrochia H, Aubert-Bringer E, Do Trinh P, Guilpain P. Idiopathic granulomatous mastitis responding to oral prednisone. Breast J 2020; 26: 281-283. (PMID: 31686425) [Crossref]
  • 21. Boukaidi ML, Ghazli M, Bennani O, Hermas S, Soummani A, Bouhya S. et al. [Granulomatous recurrent mastitis during pregnancy.] Gynecol Obstet Biol Reprod (Paris) 2000; 29: 102-104. (PMID: 10675840) [Crossref]
APA toktas O, toprak n (2021). Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. , 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
Chicago toktas Osman,toprak nurşen Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. (2021): 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
MLA toktas Osman,toprak nurşen Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. , 2021, ss.283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
AMA toktas O,toprak n Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. . 2021; 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
Vancouver toktas O,toprak n Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. . 2021; 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
IEEE toktas O,toprak n "Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis." , ss.283 - 287, 2021. 10.4274/ejbh.galenos.2021.2021-2-4
ISNAD toktas, Osman - toprak, nurşen. "Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis". (2021), 283-287. https://doi.org/10.4274/ejbh.galenos.2021.2021-2-4
APA toktas O, toprak n (2021). Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. European Journal of Breast Health, 17(3), 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
Chicago toktas Osman,toprak nurşen Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. European Journal of Breast Health 17, no.3 (2021): 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
MLA toktas Osman,toprak nurşen Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. European Journal of Breast Health, vol.17, no.3, 2021, ss.283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
AMA toktas O,toprak n Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. European Journal of Breast Health. 2021; 17(3): 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
Vancouver toktas O,toprak n Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis. European Journal of Breast Health. 2021; 17(3): 283 - 287. 10.4274/ejbh.galenos.2021.2021-2-4
IEEE toktas O,toprak n "Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis." European Journal of Breast Health, 17, ss.283 - 287, 2021. 10.4274/ejbh.galenos.2021.2021-2-4
ISNAD toktas, Osman - toprak, nurşen. "Treatment Results of Intralesional Steroid Injection andTopical Steroid Administration in Pregnant Women withIdiopathic Granulomatous Mastitis". European Journal of Breast Health 17/3 (2021), 283-287. https://doi.org/10.4274/ejbh.galenos.2021.2021-2-4