Skip to main content

Advertisement

Log in

The Effect of Western Medicine Therapies on Granulomatous Mastitis: a Meta-analysis

  • Review Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

To evaluate the clinical effectiveness of various Western medical therapies on the outcomes of granulomatous mastitis (GM), we conducted a meta-analysis of studies assessing the rates of complete remission and recurrence. We searched English and Chinese databases (Cochrane Library, PubMed, EMBASE, OVID, CNKI, VIP, and WanFang) for studies reporting complete remission and recurrence rates as a result of various Western medical treatments for GM, from inception foundation to November 2017. We retrieved references for additional studies. Two reviewers independently screened the literature, extracted information according to inclusion and exclusion criteria, and assessed methodological quality according to the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using the R 3.4.2 software. Thirty eligible studies were included, including 1483 patients with GM. Surgery, oral corticosteroids, surgery combined with oral corticosteroids, and observation alone were used more frequently than were other Western medical therapies. The complete remission rate of surgery combined with oral steroids medicine (90%) was higher than that of surgery (85%) (χ2 = 0.65, p < 0.05), oral steroids (77%) (χ2 = 0.91, p < 0.05), and observation (71%) (χ2 = 1.53, p < 0.05). The recurrence rate after surgery combined oral steroids (9%) was lower than that of surgery alone (21%) (χ2= 1.12, p < 0.05) or oral steroids (21%) (χ2 = 1.06, p < 0.05); however, there was no significant difference between surgery combined with oral steroids and observation groups (χ2 = 0.21, p = 0.74 > 0.05). Surgery combined with oral corticosteroids was superior to other therapeutic approaches in Western medicine. However, clinicians should select the treatment modality according to patients’ individual features.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma[J]. Am J Clin Pathol, 1972,58(6):642–646

  2. Liu H, Zhang HW, Ding ST, et al. Clinical features of granulomatous mastitis [J]. Chinese Gen Pract, 2016,19(18):2216–2218

  3. Wang W, Yuan CS, Liu P, et al. Clinical analysis of early surgical intervention in granulomatous mastitis[J]. Xinjiang Med J,2014,44(1):82–84

  4. Farouk O, Abdelkhalek M, Abdallah A, et al. Rifampicin for idiopathic granulomatous lobular mastitis: a promising alternative for treatment[J]. World J Surg, 2017,41(5):1–9

  5. Yu HJ, Han N, Yang JM. Refractory idiopathic granulomatous mastitis: cases report and literature review[J]. Lingnan Modern Clin Surg,2015,15(1):007

  6. Akcan A, Öz A B, Dogan S, Akgün H, Akyüz M, Ok E, Gök M, Talih T Idiopathic granulomatous mastitis: comparison of wide local excision with or without corticosteroid therapy[J]. Breast Care,2014,9(2):111–115

  7. Kshirsagar VV, Male PV, Bendre M, Chavan S, Rathod S Chronic granulomatous mastitis: a therapeutic dilemma revisited[J]. Arch Int Surg, 2016;6(2):100–104

  8. Benson J R, Dumitru D. Idiopathic granulomatous mastitis: presentation, investigation and management[J]. Future Oncol, 2016, 12(11):1381–1394

  9. Luo ML, Tan HZ, Zhou Q et al. Realizing the meta-analysis of single rate in R software[J]. J Evid Based Med,2013,13(2):181–184

  10. Higgins JP, Thompson SG, Deeks JJ, Altman DG Measuring inconsistency in meta-analyses[J]. Br Med J, 2003, 327(7414):557–560

  11. 2006 Wang JL, Editor. Evidence based medicine, second edition, Beijing: People’s Medical Publishing House,,81,84-85,87-88,89–90

  12. Aghajanzadeh M, Hassanzadeh R, Alizadeh S S, et al. Granulomatous mastitis: presentations, diagnosis, treatment and outcome in 206 patients from the north of Iran[J]. Breast, 2015, 24(4):456–460

  13. Sheybani F, Sarvghad M R, Naderi H R, Gharib M Treatment for and clinical characteristics of granulomatous mastitis[J]. Obstet Gynecol, 2015, 125(4):801–807

  14. Sakurai K, Fujisaki S, Enomoto K, Amano S, Sugitani M Evaluation of follow-up strategies for corticosteroid therapy of idiopathic granulomatous mastitis[J]. Surg Today, 2011, 41(3):333–337

  15. Mahlab-Guri K, Asher I, Allweis T, Diment J., Sthoeger Z.M., Mavor E. Granulomatous lobular mastitis[J]. Isr Med Assoc J, 2015, 17(8):476–480

  16. Kazuhisa A, Nobuyuki T, Masamichi K, et al. Therapeutic strategy for granulomatous lobular mastitis: a clinicopathological study of 12 patients[J]. Nagoya J Med Sci, 2013, 75(3–4):193

  17. Elzahaby I A, Khater A, Fathi A, et al. Etiologic revelation and outcome of the surgical management of idiopathic granulomatous mastitis: an Egyptian centre experience[J]. Breast Dis, 2016, 36(4):1–8

  18. Girgin S, Uslukaya Ö, Yılmaz EE et al (2015) Granulomatous mastitis: a retrospective review of 49 patients[J]. Dicle Med J 42(1):22–27

    Article  Google Scholar 

  19. Gunay G, Ali A, Fugen A, et al. Medical and surgical treatment of idiopathic granulomatous lobular mastitis: a benign inflammatory disease mimicking invasive carcinoma[J]. J Breast Cancer, 2012, 15(1):119

  20. Mo H S, Hui C D, Kyung L S, et al. Experience of treatment of patients with granulomatous lobular mastitis[J]. J Korean Surg Soc, 2013, 85(1):1–6

  21. Karanlik H, Ozgur I, Simsek S, Fathalizadeh A, Tukenmez M, Sahin D, Dursun M, Kurul S Can steroids plus surgery become a first-line treatment of idiopathic granulomatous mastitis?[J]. Breast Care, 2014, 9(5):338–342

  22. Kayahan M, Kadioglu H, Muslumanoglu M. Management of patients with granulomatous mastitis: analysis of 31 cases[J]. Breast Care, 2012, 7(3):226–230

  23. Kiyak G, Dumlu E G, Kilinc I, et al. Management of idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment[J]. BMC Surg, 2014, 14(1):1–5

  24. Lin M, Liu J, Guo F, et al. Granulomatous mastitis: presentation, treatment, and outcome[J]. Am Surg, 2014, 80(3):82–83

  25. Ebru Sen; Oran MD, Gürdal S Ö, Yücel Yankol M D, et al. Management of idiopathic granulomatous mastitis diagnosed by core biopsy: a retrospective multicenter study[J]. Breast J,2013,19(4):411–418

  26. Pandey T S, Mackinnon J C, Bressler L, Millar A., Marcus E. E., Ganschow P. S. Idiopathic granulomatous mastitis--a prospective study of 49 women and treatment outcomes with steroid therapy[J]. Breast J, 2014, 20(3):258–266

  27. Salehi M, Salehi H, Moafi M, et al. Comparison of the effect of surgical and medical therapy for the treatment of idiopathic granulomatous mastitis[J]. J Res Med Sci Off J Isfahan University Med Sci, 2014, 19(1):5–8

  28. Shin Y D, Park S S, Song Y J, Son SM, Choi Y J Is surgical excision necessary for the treatment of granulomatous lobular mastitis?[J]. BMC Womens Health, 2017, 17(1):49

  29. Yabanoğlu H, Çolakoğlu T, Belli S, Aytac H O, Bolat F A, Pourbagher A, Tezcaner T, Yildirim S, Haberal M A comparative study of conservative versus surgical treatment protocols for 77 patients with idiopathic granulomatous mastitis[J]. Breast J, 2015, 21(4):363, 369

  30. Chen ZW, Huang XX, Wang HM, Clinical experience in operation combined oral steroids treatment of granulomatous mastitis[J]. Fujian Med Univ J,2015,49(3):191–192

  31. Cui RZ, Pan CX, Yang JH. Comparative analysis between oral steroids treatment and extended resection treatment of granulomatous mastitis[J]. Guide of China Medicine,2015,13(14):91–92

  32. Hu XD. The curative effect analysis of wide excision method to the cure of granulomatous lobular mastitis[J]. China Continuing Medical Education,2015,7(6):53–54

  33. Tan YF. Comparison of efficacy between oral steroids treatment and extended resection treatment of granulomatous mastitis[J]. Modern Diagonsis and Treatment,2016,27(21):4140–4141

  34. Tan LB, Fan FF, Li ZW. Clinical analysis of granulomatous mastitis: a review of 35 cases[J]. China Modern Doctor,2016,54(24):45–47

  35. Wang L. Clinicopathologic feature and the effect of operation combined oral steroids treatment of granulomatous matitis[J]. J Clin Med,2016,3(59):11723

  36. Wu HS, Wu JC, Zheng C, et al. Clinical study of conservative treatment for 120 patients with granulomatous mastitis[J]. Chinese Journal of Bases and Clinics in General Surgery,2016,23(2):225–228

  37. Yan N, Peng WQ, Huang YK, et al. A comparative study of different methods in granulomatous lobular mastitis treatment[J]. J Clin Exp Med,2013,12(5):368–389

  38. Lai E C, Chan W C, Ma T K, et al. The role of conservative treatment in idiopathic granulomatous mastitis[J]. Breast J, 2005, 11(6):454–456

  39. Dong HY, Tang P, Zhong XJ et al (2015) Clinical analysis of granulomatous mastitis: A review of 26 cases[J]. Chinese Journal of Difficult and Complicated Cases 14(4):413–415

    Google Scholar 

  40. Li QJ, Zhang L. Clinical analysis of idiopathic granulomatous mastitis : a review of 22 cases[J]. Chinese Journal of Bases and Clinics in General Surgery,2015,22(7):858–862

  41. Sun HD. Efficacy analysis of extended resection on patients of granulomatous mastitis[J]. Chinese Journal of Trauma and Disability Medicine,2014,22(14):96–97

  42. Co M, Cheng V C C, Wei J, Wong S CY, Chan S MS, Shek T, Kwong A Idiopathic granulomatous mastitis: a 10-year study from a multicentre clinical database[J]. Pathology,2018,50(7):742–747

  43. Ahmed B, Al-Khaffaf H (2009) Prevalence of significant asymptomatic carotid artery disease in patients with peripheral vascular disease: a meta-analysis. Eur J Vasc Endovasc Surg 37(3):262–271

    Article  CAS  PubMed  Google Scholar 

  44. Altintoprak F, Kivilcim T, Ozkan O V. Aetiology of idiopathic granulomatous mastitis[J]. World J Clin Cases,2014,2(12):852, 858

  45. Baslaim MM, Khayat HA, Al-Amoudi SA. Idiopathic granulomatous mastitis: a heterogeneous disease with variable clinical presentation[J]. World J Surg,2007,31:1677–1681

  46. Fazzio R T, Shah S S, Sandhu N P, Glazebrook K N Idiopathic granulomatous mastitis: imaging update and review[J]. Insights into Imaging,2016,7(4):531–539

  47. Larsen L J H, Peyvandi B, Klipfel N, Grant E, Iyengar G Granulomatous lobular mastitis: imaging, diagnosis, and treatment[J]. Am J Roentgenol,2009,193(2):574–581

  48. Tse GMK, Poon CSP, Law BKB et al (2003) Fine needle aspiration cytology of granulomatous mastitis[J]. J Clin Pathol 56(7):519–521

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Gupta RK.Fine needle aspiration cytology of granulomatous mastitis:a study of 18 cases.[J]Acta Cytol,2010,54(2):138–141

  50. Yau Farrah M, Sheina A, Kuusk et al (2010) The surgical management of granulomatous mastitis[J]. Ann Plast Surg 64(1):9–16

    Article  CAS  PubMed  Google Scholar 

  51. Kim J, Tymms K E, Buckingham J M. Methotrexate in the management of granulomatous mastitis[J]. ANZJ Sur,2003,73(4):247–249

  52. Schmajuk G, Genovese MC (2009) First report of idiopathic granulomatous mastitis treated with methotrexate monotherapy[J]. J Rheumatol 36(7):1559–1559

    Article  PubMed  Google Scholar 

  53. Patel R A, Strickland P, Sankara I R, Pinkston G., Many W., Rodriguez M. Idiopathic granulomatous mastitis: case reports and review of literature[J]. J Gen Intern Med,2010,25(3):270–273

Download references

Funding

This work was financially supported by the Natural Science Foundation of Hunan Province of China (Grant No. 2017JJ3431).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Boni Ding.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Q., Ding, B., Qian, L. et al. The Effect of Western Medicine Therapies on Granulomatous Mastitis: a Meta-analysis. Indian J Surg 81, 366–378 (2019). https://doi.org/10.1007/s12262-019-01883-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-019-01883-7

Keywords

Navigation