FRI0500 Idiopathic Granulomatous Mastitis: A Single Center Experience. (15th July 2016)

• Record Type: Journal Article
• Authors: Cinar, M.; Yilmaz, S.; Cakar, M.; Pay, S.
• Is Part Of: Annals of the rheumatic diseases. Volume 75(2016)Supplement 2
• Page Start: 619
• Page End: 619
• Publication Date: 2016-07-15
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2016-eular.5289
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast. Difficulties can be experienced in the treatment of IGM due to the lack of a common consensus in the literature. Treatment options include corticosteroids, surgical treatment, immunosuppressive drugs and conservative treatment with antibiotics. Objectives: To present our experience about patients with IGM on immunosuppressive therapy. Methods: The data of patients with a diagnosis of IGM under immunosuppressive therapy followed in the rheumatology outpatient clinic of a tertiary center enrolled between September 2010 and August 2015 were evaluated retrospectively. 16 histopathologically diagnosed patients receiving immunosuppressive therapy were evaluated for their treatments and treatment responses. Results: The mean age of the patients, the average duration of immunosuppressive therapy and the average follow-up period were 35.9±6.5 years, 19.6±14.1 months and 28.3±17.8 months, respectively. Initially, 15 patients received (93.8%) steroids and methotrexate, and 1 patient (6.2%) was treated only with steroids. All patients responded well to initial therapy. Eight (53.3%) patients achieved remission with steroid + methotrexate. 2 of the other 7 patients relapsed after discontinuation of steroids and 1 after discontinuation of steroid + methotrexate. A positive response was obtained after the restart of treatment with steroids and methotrexate in these patients. Of these 7 patients, no recurrence was observed in 3 (42.9%) patients with only methotrexate and in 4 (57.1%) patients in the maintenance treatment with steroids and methotrexate. Lowered dose of steroid was associated with recurrence during follow-up of the patient taking only steroids as the initial treatment. 5 patients (33.3%) taking methotrexate had drug side effects, not necessitate stopping the treatment. Conclusions: Systemic immunosuppressive therapy is safe and effective in IGM. Azathioprine and methotrexate have been the most frequently used immunosuppressive drugs in the literature. Our experience with methotrexate-based regimen allows the rapid reduction of the steroid dose and leads to remission. References: Konan A, Kalyoncu U, Dogan I, Kiliç YA, Karakoç D, Akdogan A, Kiraz S, Kaynaro Lu V, Onat D. Combined long-term steroid and immunosuppressive treatment regimen in granulomatous mastitis. Breast Care (Basel). 2012 Aug;7(4):297–301. Sheybani F, Sarvghad M, Naderi HR, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis.Obstet Gynecol. 2015 Apr;125(4):801–7. Disclosure of Interest: None declared