AB1276 EVALUATION OF DRUG-FREE REMISSION RATES IN IDIOPATHIC GRANULOMATOUS MASTITIS

Abstract

BackgroundIdiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease. There is no clear consensus on its treatment yet (1).ObjectivesThe aim of the study was to evaluate the rates of drug-free remission of the patients with IGM in a period of three-year follow-up.MethodsA total of 76 patients who were followed-up with biopsy proven IGM, between February 2011 and November 2021 in rheumatology outpatient clinic of Gulhane Training and Research Hospital, were evaluated retrospectively. To analyze long-term outcomes, 55 patients who were followed up for 3 years were included in the study. Data regarding the demographic and clinical characteristics of the patients were obtained from patients’ files.ResultsThe study included 55 female patients with a mean age of 36.8 ± 6.3 years. Forty-nine (89.1%) patients received immunosuppressive treatment, one (1.8%) patient received postoperative immunosuppressive treatment, 3 (5.4%) patients had immunosuppressive treatment due to recurrence after surgery, and 1 (1.8%) patient underwent only surgery. One (1.8%) patient had no treatment for IGM. Patients who received immunosuppressive drugs for initial treatment, 38 (69.1%) received methotrexate (MTX) and corticosteroids (CS), 7 (13.2%) received azathioprine (AZA) and CS, 3 (5.6%) received only CS and 1 (1.8%) received cyclosporine A (CsA) and CS. Four (7.2 %) patients had received MTX after surgery. At 3-year follow-up 54 (98.1%) patients were in drug-free remission. The median duration of drug-free remission in patients receiving MTX plus CS, CS, and azathioprine plus CS was 19.7, 32.9, and 14.7 months, respectively. One patient who received CsA plus CS was in drug-free remission for 28.3 months. The median duration of treatment with combination of CS and other immunosuppressives was 6.7 months. The median duration of immunosuppressive treatment was 15.8 months (Table 1). Recurrence was observed in 4 (80%) patients who did not receive immunosuppressive therapy after surgery. Three (75%) of these patients received MTX due to recurrence, and remission was achieved.Table 1.Duration of immunosuppressive treatment and drug-free remission of the patientsTreatmentDuration of immunosuppressives, (n=53)Duration of drug-free remission, (n=54)Only corticosteroids (month)*4.6 (2.9-5.8)32.9 (32.4-33.4)Methotrexate (month)*19.7 (2.8-32.4)19.7 (2.7-32.4)Azathioprine (month)*16.2 (11.0-30.1)14.7 (8.8-22.9)Cyclosporine (month)7.628.3Total (month)*15.8 (2.9-34.3)21.2 (2.7-36.6)* Variables as median, (minimum - maximum)ConclusionImmunosuppressives provide a remarkably high sustained remission and maintain a longer drug-free remission in patients with IGM.