The Neoadjuvant-Like effect of Steroids in Idiopathic Granulomatous Mastitis Management | ||
| Ain Shams Journal of Surgery | ||
| Volume 18, Issue 4, October 2025, Pages 338-347 PDF (575.42 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/asjs.2025.409995.1225 | ||
| Authors | ||
| Amira Maher* 1; Fadi Hani Wahba Mikhaail2; Abanoub S. N. Sadary2; Remon Mamdouh Mahfouz2; Ayman Magdy Botrous Ghaly2 | ||
| 1Galala University, Attaka, Suez, Egypt | ||
| 2Breast Surgery Unit, Ain Shams University Hospital, Cairo, Egypt | ||
| Abstract | ||
| Introduction: Idiopathic granulomatous mastitis (IGM) management is considered a current dilemma. However the benign nature of the disease mimics breast carcinoma both clinically and radiologically and has a great rate of relapse and recurrence. Steroids are nowadays implemented in the management of IGM. In our study, we standardized the corticosteroids as a presurgical management in management of idiopathic granulomatous mastitis due its neoadjuvant-like effect in decreasing the size of the lesion, to control the disease progression and to decrease the recurrence rates. Aim of work: To verify the effect of steroids in the treatment of idiopathic granulomatous mastitis. Patients and methods: This is a prospective study which includes patients diagnosed with idiopathic granulomatous mastitis from Ain-Shams University Hospital’s breast clinic and Egyptian railway medical center breast surgery unit between 2018 to 2024. Fifty-three patients were included in our study, all patients received corticosteroid therapy followed by surgical excision for the residual lesion. Results: Clinical and radiological regression was reported after steroid administration resulting in volume reduction from 7.49 ± 2.216 to 1.73 ± 1.158 cm3 and complete clinical and radiological regression was observed in 11 cases.40 patients were proceeded to wide local excision for the residual granulomatous lesions. 7 patients were presented with ipsilateral recurrence with average disease-free interval ranging from 2 to 6 months after discontinuation of steroids. All those patients showed complete resolution after steroids therapy and didn’t perform a wide local excision. Cosmetic outcome was excellent in 49.1%. Conclusion: Corticosteroid therapy has a neoadjuvant-like effect resulting in significant reduction of the lesion burden and improving surgical feasibility and cosmetic results. | ||
| Keywords | ||
| Corticosteroid; granulomatous mastitis; breast abscess | ||
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