Abstract
Objective To explore whether Chuang Ling Ye (CLY), a traditional Chinese herbal medicine compound, could improve the treatment of idiopathic granulomatous mastitis (IGM) via decreasing inflammatory response. Methods Herein, 40 patients with IGM who had wounds requiring dressing change were enrolled and randomly divided into two groups: the CLY group and the control group. The size of the neoplasm and pain score of patients were followed-up for 4 weeks. Local tissues were taken during dressing change and examined by commercial enzyme-linked immunosorbent assay (ELISA) kits. The levels of inflammatory markers, including interleukin-1β (IL-1β), IL-2, IL-6, interferon gamma (IFN-γ), and tumor necrosis factor-α (TNF-α) were measured. Results After treatment, the size of the neoplasm in the CLY group was significantly smaller than that in the control group (14.28 cm ± 8.96 cm vs. 21.14 cm ± 0.12 cm, P=0.038), and the pain scores were markedly reduced (P=0.004). Besides, CLY downregulated the expression levels of IL-1β, IFN-γ, and TNF-α. Conclusion External use of CLY could reduce the neoplasm of IGM by inhibiting local inflammation. This trial is registered with ChiCTR1800017744.
Highlights
Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease with an estimated incidence of 2.4 per 100,000 women and 0.37% in the United States, while its incidence is higher among Asian populations [1]. e leading symptom of IGM is a painful neoplasm
IGM is diagnosed by histopathology only. e disease is characterized by formation of granuloma in combination with a localized infiltrate of multinucleated giant cells, lymphocytes, and plasma cells [3]. e etiopathogenesis of IGM reported in the literature included breast dysplasia, nipple deformity, smoking, and taking psychotropic drugs, leading to abnormal secretion of lipid substances in mammary duct endothelium, blockage of ducts caused by accumulation of secretions, and chronic inflammation [4], which suggested that inhibiting inflammation may be effective in the treatment of IGM
Lei et al [8] demonstrated that surgical management have a high complete remission/resolution (CR) rate with a relatively low recurrence rate, with or without steroids. us, it is highly appropriate for patients requiring rapid remission
Summary
Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast disease with an estimated incidence of 2.4 per 100,000 women and 0.37% in the United States, while its incidence is higher among Asian populations [1]. e leading symptom of IGM is a painful neoplasm. E leading symptom of IGM is a painful neoplasm. Management of IGM cases remains controversial with proponents of initial surgical or medical therapies and each one has its associated complications, which may be worse than the original symptoms of IGM [5]. E main treatment option for IGM is surgery. Antibiotics and surgical incision can be used, and the surgery can be performed after the neoplasm shrinks. Erefore, the main target of surgical treatment is to completely and thoroughly remove the lesions in the large lacteal duct avoiding recurrence. Lei et al [8] demonstrated that surgical management have a high complete remission/resolution (CR) rate with a relatively low recurrence rate, with or without steroids. Lei et al [8] demonstrated that surgical management have a high complete remission/resolution (CR) rate with a relatively low recurrence rate, with or without steroids. us, it is highly appropriate for patients requiring rapid remission
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