Archives of Gynecology and Obstetrics

, Volume 284, Issue 5, pp 1189–1195

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

Authors

    • Department of SurgeryDiyarbakir Education and Research Hospital
  • Zulfu Arikanoglu
    • Department of SurgeryDiyarbakir Education and Research Hospital
  • Ayhan Senol
    • Department of RadiologyDiyarbakir Education and Research Hospital
  • Nilgun Sogutcu
    • Department of PathologyDiyarbakir Education and Research Hospital
  • Murat Basbug
    • Department of SurgeryDiyarbakir Education and Research Hospital
  • Erhan Yeniaras
    • Department of AnaesthesiologyDiyarbakir Education and Research Hospital
  • Yusuf Yagmur
    • Department of SurgeryDiyarbakir Education and Research Hospital
General Gynecology

DOI: 10.1007/s00404-010-1825-2

Cite this article as:
Akbulut, S., Arikanoglu, Z., Senol, A. et al. Arch Gynecol Obstet (2011) 284: 1189. doi:10.1007/s00404-010-1825-2

Abstract

Purpose

The treatment of choice for idiopathic granulomatous mastitis (IGM) has not yet been established. There are limited data on the use of methotrexate (MTX) in the treatment of IGM. Herein, we investigated the role of MTX in the treatment of IGM patients.

Methods

We present four new cases of IGM treated with MTX and a review of the English language literature concerning the use of MTX in the treatment of IGM.

Results

We prospectively investigated the clinicopathological features of four female patients (aged 28–37 years) who were multiparous and had used oral contraceptives. The patients were administered 7.5–15 mg MTX over 2–6 months. No recurrence was detected during the follow-up period of 4–8 months. In five published studies on MTX use in IGM, data were available for 12 patients aged 21–40 years. In nine patients, treatment was changed to MTX because of a lack of response to steroids, recurrence or steroid-induced diabetes mellitus. Steroids were used in combination with MTX as an initial treatment choice in three patients. Satisfactory results were achieved in ten patients treated with MTX, and only two demonstrated recurrence despite the treatment and underwent mastectomy.

Conclusion

MTX in the present cases of IGM was effective, prevented complications and limited corticosteroid side effects.

Keywords

MethotrexateIdiopathic granulomatous mastitisBreast

Abbreviations

GM

Granulomatous mastitis

IGM

Idiopathic granulomatous mastitis

DM

Diabetes mellitus

US

Ultrasonography

MG

Mammography

MRI

Magnetic resonance imaging

MTX

Methotrexate

OCs

Oral contraceptive

TB

Tuberculosis

Copyright information

© Springer-Verlag 2010