The role of clinical and radiological risk factors and triglyceride-glucose index in predicting recurrence of idiopathic granulomatous mastitis

Abstract

Aims: Idiopathic granulomatous mastitis (IGM) is a rare breast disease characterised by granulomatous inflammation that is clinically and radiologically similar to breast cancer. The main challenge in treating IGM is the development of treatment resistance and recurrence. Many studies have been carried out in the literature to identify markers of recurrence in this disease, but no satisfactory results have been obtained. The aim of this study was to determine the role of clinical, radiological and laboratory parameters in predicting recurrence in patients with IGM and to evaluate the relationship between the triglyceride-glucose (TyG) index and IGM recurrence. Methods: In this study, the electronic medical records of 92 patients who were histopathologically diagnosed with IGM between January 2016 and February 2024 were retrospectively reviewed. Patients were divided into two groups according to recurrence status. Clinical, radiological and laboratory parameters were compared between groups. Results: Recurrence was detected in 26.1% of the patients included in the study and the average follow-up period was 27.6±4.6 months. No statistically significant difference was found between the two groups with regard to age, follow-up time, menopausal status, breastfeeding, oral contraceptive use, smoking history, parity and pathological diagnosis (p>0.05 for all). In univariate analysis, axillary lymphadenopathy, long duration of breastfeeding, low serum albumin globulin ratio and high TyG index were identified as risk factors for IGM recurrence. In multivariate regression analysis, long duration of breastfeeding (p=0.042, OR: 4.12; 95% confidence interval (CI), 1.05-16.11) and high TyG index (p=0.005, OR: 5.75; 95% confidence interval (CI), 1.69-19.54) were found to be independent risk factors for recurrence. Conclusion: Study results suggest that a high TyG index at initial presentation and long duration of breastfeeding increase the risk of recurrence in IGM patients. Therefore, questioning the breastfeeding history at the time of admission and determining and analyzing the TyG index can identify patients at high risk for recurrence.

Keywords

• Idiopathic granulomatous mastitis
• recurrence
• ultrasonography
• triglyceride-glucose index
• axillary lymphadenopathy
• breastfeeding duration

İdiyopatik granülomatöz mastit nüksünü öngörmede klinik ve radyolojik risk faktörleri ile trigliserid-glukoz indeksinin rolü

Abstract

Amaç İdiyopatik granülomatöz mastit (IGM), klinik ve radyolojik olarak meme kanseri ile benzerlik gösteren granülomatöz inflamasyon ile seyreden nadir görülen meme hastalığıdır. IGM tedavisindeki en önemli zorluk tedaviye direnç ve nüks gelişimidir. Literatürde bu hastalığın nüks belirteçlerini belirlemeye yönelik birçok çalışma yapılmıştır fakat tatmin edici bir sonuca varılamamıştır. Bu çalışmada idiopatik granülomatöz mastit hastalarında nüksü öngörmede klinik, radyolojik ve laboratuvar parametrelerin rolünün belirlenmesi ve trigliserit-glikoz (TyG) indeksi ile IGM nüksü arasındaki ilişkinin değerlendirmesi amaçlanmıştır. Hastalar ve Yöntemler Bu çalışmada Ocak 2016 ile Şubat 2024 tarihleri arasında histopatolojik olarak IGM tanısı alan 92 hastanın elektronik tıbbi kayıtları geriye dönük incelendi. Hastalar nüks durumuna göre iki gruba ayrıldı. Gruplar arası klinik, radyolojik ve laboratuvar parametreleri karşılaştırıldı. Bulgular Çalışmaya dahil edilen hastaların %261’inde nüks saptandı ve ortalama takip süresi 27.6±4.6 ay idi. Her iki grup arasında yaş, takip süresi, menapozal durum, emzirme, oral kontraseptif, sigara kullanım öyküsü, parite, patolojik tanı ve tedavi şekli arasında istatiksel olarak anlamlı farklılık saptanmadı (tümü için p >0.05). Tek değişkenli analizde axiller lymphadenopathy, uzun emzirme süresi, düşük serum albümin globülin oranı ve yüksek TyG indeksi IGM nüksünde risk faktörleri olarak belirlendi. Çok değişkenli regresyon analizde ise uzun emzirme süresinin (p =0.042, OR: 4.12; 95% confidence interval (CI), 1.05-16.11) ve yüksek TyG indeksinin (p =0.005, OR: 5.75; 95% confidence interval (CI), 1.69-19.54) nüks acısından bağımsız risk faktörleri oldukları belirlendi. Sonuç Çalışma bulguları, ilk başvuru sırasında yüksek TyG indeksinin ve uzun emzirme süresinin IGM hastalarında nüks riskini arttırdığını göstermektedir. Bu nedenle başvuru sırasında emzirme öyküsünün iyi sorgulanması ve TyG indeksinin belirlenip analiz edilmesi nüks açısından yüksek risk altındaki hastaları belirleyebilir.

Keywords

• İdiyopatik granülomatöz mastit
• nüks
• trigliserit-glikoz indeksi
• axiller lenfadenopati
• emzirme süresi

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