Evaluation of the efficacy of intralesional triamcinolone injection therapy in patients with granulomatous mastitis: a comparative study with oral methylprednisolone

Abstract

Aims: This study aims to compare the efficacy of oral steroid therapy with the combination of topical and intralesional steroid (TILS) therapy in patients with granulomatous mastitis (GM). Methods: This is a single-center retrospective longitudinal study. Women with a diagnosis of GM who applied to Medipol Universty Pendik Hospital General Surgery Clinic between January 2020 and April 2022 were included in the study. Participants received TILS or peroral steroid (POS) treatment in sequential order, and each patient received only one of the treatment options. Participants were evaluated by physical examination, USG, and radiography before and after treatment to assess lesion size, side, number of foci, skin characteristics, and the presence of pain. The clinical and radiological findings were compared betwen the groups at the end of the 6-month follow-up and the participants were followed up for the next 12 months to demonstrate the efficacy. Results: A total of 52 women participated in the study, with 26 in the POS group and 26 in the TILS group. The mean age was 33.33+6.94 years and similar between the two groups (p=0.831). Three patients (11.53%) in the TILS group and 7 patients (26.92%) in the POS group were nonresponders to treatment (p=0.159). Given the nonresponders, GM lesions persisted in one patient (3.84%) in the TILS group and 3 patients (11.53%) in the POS group at the end of the study (p=0.610). At the end of the 12-month follow-up, five patients (19.2%) in the TILS group and 20 patients (76.9%) in the POS group who achieved a complete remission at the posttreatment 6 months experienced disease recurrence (p<0.001). Cox regression analysis revealed that only foci in the breast (p=0.043) and abscess formation (p=0.018) were independent risk factors for GM recurrence. In the TILS group, intervention-related complications were not observed while blood pressure and glucose elevation, weight gain, and edema were found in the POS group (p<0.05). Conclusion: TILS provides similar efficacy to systemic steroid therapy, with a lower recurrence rate and potential for side effects.

Keywords

• Granulomatous mastitis
• Intralesional steroid
• Breast abscess

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