Moderate-Dose Prednisolone as an Effective Substitute for High-Dose Prednisolone in the Treatment of Idiopathic Granulomatous Mastitis: A Retrospective Study
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Abstract
Corticosteroids, generally prescribed at high doses, have been used with good results in the treatment of idiopathic granulomatous mastitis (IGM). However, side effects of steroids are a serious concern, and prescribing lower doses sound safer if they provide similar efficacy. Thus, this study was performed to investigate the effect of moderate-dose versus high-dose prednisolone on IGM. Medical records of IGM patients were evaluated retrospectively. Patients who received prednisolone were classified as the moderate-dose group (MDG, <25 mg/day) and the high-dose group (HDG, ≥25 mg/day); their response and recurrence rates were compared. Among 108 patients, 82.5% in HDG and 85.3% in MDG responded to treatment (P=0.7). Total recurrence was 21.7% and 22% in HDG and MDG, respectively (P=0.984). Moderate doses of corticosteroids may be used to treat IGM patients without decreasing the treatment efficacy. Prospective randomized trials are necessary to further clarify this issue.
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2. Yin Y, Liu X, Meng Q, Han X, Zhang H, Lv Y. Idiopathic granulomatous mastitis: etiology, clinical manifestation, diagnosis and treatment. Journal of Investigative Surgery, 2022;7;35(3):709-20.
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6. Montazer M, Dadashzadeh M, Moosavi Toomatari SE. Comparison of the Outcome of Low Dose and High-Dose Corticosteroid in the Treatment of Idiopathic Granulomatous Mastitis. Asian Pac J Cancer Prev, 2020;21(4):993-996.
7. Mizrakli T, Velidedeoglu M, Yemisen M, Mete B, Kilic F, Yilmaz H et al. Corticosteroid treatment in the management of idiopathic granulomatous mastitis to avoid unnecessary surgery. Surg Today, 2015;45(4):457-65.
8. Godazandeh G, Shojaee L, Alizadeh-Navaei R, Hessami A. Corticosteroids in idiopathic granulomatous mastitis: a systematic review and meta-analysis. Surg Today, 2021;1:1-9.
9. Kaviani A, Vasigh M, Omranipour R, Mahmoudzadeh H, Elahi A, Farivar L, et al. Idiopathic granulomatous mastitis: Looking for the most effective therapy with the least side effects according to the severity of the disease in 374 patients in Iran. Breast J, 2019;25(4):672-677.
10. DeHertogh DA, Rossof AH, Harris AA, Economou SG.Prednisone management of granulomatous mastitis. N Engl J Med, 1980;303(14):799-800.
11. Erozgen F, Ersoy YE, Akaydin M, Memmi N, Celik AS, Celebi F, et al. Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Res Treat, 2010;123:447–52.
12. Néel A, Hello M, Cottereau A, et al. Long-term outcome in idiopathic granulomatous mastitis: a western multicentre study. QJM, Int J Med, 2013;106:433–41.
13. Pandey TS, Mackinnon JC, Bressler L, et al. Idiopathic granulomatous mastitis--a prospective study of 49 women and treatment outcomes with steroid therapy. Breast J, 2014;20:258–66.
14. Skandarajah A, Marley L. Idiopathic granulomatous mastitis: a medical or surgical disease of the breast? ANZ J Surg, 2015;85:979–82.
15. Yilmaz TU, Gurel B, Guler SA, Baran MA, Erşan B, Duman S, et al. Scoring idiopathic granulomatous mastitis: an effective system for predicting recurrence? Eur J Breast Health, 2018;14:112–6.
16. Cetin K, Sıkar HE, Goret NE, Rona G, Barışık NÖ, Küçük HF, et al. Comparison of topical, systemic, and combined therapy with steroids on idiopathic granulomatous mastitis: a prospective randomized study. World J Surg, 2019;43:2865–73.
17. Sakurai K, Fujisaki S, Enomoto K, Amano S, Sugitani M. Evaluation of follow-up strategies for corticosteroid therapy of idiopathic granulomatous mastitis. Surg Today, 2011;41:333–7.
18. Salehi M, Salehi H, Moafi M, Aleban R, Tabatabaei SA, Salehi M, et al. Comparison of the effect of surgical and medical therapy for the treatment of idiopathic granulomatous mastitis. J Res Med Sci, 2014; 19(Suppl 1):S5-8.
19. Sheybani F, Sarvghad M, Naderi H, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol, 2015;125:801–7.
2. Yin Y, Liu X, Meng Q, Han X, Zhang H, Lv Y. Idiopathic granulomatous mastitis: etiology, clinical manifestation, diagnosis and treatment. Journal of Investigative Surgery, 2022;7;35(3):709-20.
3. Metanat S, Jobaneh YS, Noori M, Sadeghi F, Mirzapour A, Mashoori N, et al. Global distribution of idiopathic granulomatous mastitis: a scoping review: IGM global distribution. Arch Breast Cancer, 2022;9(3-SI):261-71.
4. Alipour S, Tabatabaeian M, Nafissi N, Fattahi AS, Astaraki S, Zahernia-Shahrbabaki Z, et al. Idiopathic Granulomatous Mastitis and History of Hypothyroidism: Intervening Data of a Prospective Multicenter Trial and Meta-Analysis of the Existing Literature: IGM and Hypothyroidism. Arch Breast Cancer,2023;10(1):38-47.
5. Koksal H. Medical Treatment and Prognosis: Idiopathic Granulomatous Mastitis. 1st ed. pp. 129-152. Springer Nature. Switzerland. 2023.
6. Montazer M, Dadashzadeh M, Moosavi Toomatari SE. Comparison of the Outcome of Low Dose and High-Dose Corticosteroid in the Treatment of Idiopathic Granulomatous Mastitis. Asian Pac J Cancer Prev, 2020;21(4):993-996.
7. Mizrakli T, Velidedeoglu M, Yemisen M, Mete B, Kilic F, Yilmaz H et al. Corticosteroid treatment in the management of idiopathic granulomatous mastitis to avoid unnecessary surgery. Surg Today, 2015;45(4):457-65.
8. Godazandeh G, Shojaee L, Alizadeh-Navaei R, Hessami A. Corticosteroids in idiopathic granulomatous mastitis: a systematic review and meta-analysis. Surg Today, 2021;1:1-9.
9. Kaviani A, Vasigh M, Omranipour R, Mahmoudzadeh H, Elahi A, Farivar L, et al. Idiopathic granulomatous mastitis: Looking for the most effective therapy with the least side effects according to the severity of the disease in 374 patients in Iran. Breast J, 2019;25(4):672-677.
10. DeHertogh DA, Rossof AH, Harris AA, Economou SG.Prednisone management of granulomatous mastitis. N Engl J Med, 1980;303(14):799-800.
11. Erozgen F, Ersoy YE, Akaydin M, Memmi N, Celik AS, Celebi F, et al. Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Res Treat, 2010;123:447–52.
12. Néel A, Hello M, Cottereau A, et al. Long-term outcome in idiopathic granulomatous mastitis: a western multicentre study. QJM, Int J Med, 2013;106:433–41.
13. Pandey TS, Mackinnon JC, Bressler L, et al. Idiopathic granulomatous mastitis--a prospective study of 49 women and treatment outcomes with steroid therapy. Breast J, 2014;20:258–66.
14. Skandarajah A, Marley L. Idiopathic granulomatous mastitis: a medical or surgical disease of the breast? ANZ J Surg, 2015;85:979–82.
15. Yilmaz TU, Gurel B, Guler SA, Baran MA, Erşan B, Duman S, et al. Scoring idiopathic granulomatous mastitis: an effective system for predicting recurrence? Eur J Breast Health, 2018;14:112–6.
16. Cetin K, Sıkar HE, Goret NE, Rona G, Barışık NÖ, Küçük HF, et al. Comparison of topical, systemic, and combined therapy with steroids on idiopathic granulomatous mastitis: a prospective randomized study. World J Surg, 2019;43:2865–73.
17. Sakurai K, Fujisaki S, Enomoto K, Amano S, Sugitani M. Evaluation of follow-up strategies for corticosteroid therapy of idiopathic granulomatous mastitis. Surg Today, 2011;41:333–7.
18. Salehi M, Salehi H, Moafi M, Aleban R, Tabatabaei SA, Salehi M, et al. Comparison of the effect of surgical and medical therapy for the treatment of idiopathic granulomatous mastitis. J Res Med Sci, 2014; 19(Suppl 1):S5-8.
19. Sheybani F, Sarvghad M, Naderi H, Gharib M. Treatment for and clinical characteristics of granulomatous mastitis. Obstet Gynecol, 2015;125:801–7.
| Files | ||
| Issue | Articles in Press: Vol 64 No 02 (2026) | |
| Section | Original Articles | |
| Keywords | ||
| Corticosteroid Granulomatous mastitis Prednisolone Recovery Recurrence | ||
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How to Cite
1.
Omranipour R, Mashoori N, Alipour S, Saberi A. Moderate-Dose Prednisolone as an Effective Substitute for High-Dose Prednisolone in the Treatment of Idiopathic Granulomatous Mastitis: A Retrospective Study. Acta Med Iran. 2026;64(02).
