Study on applied timing of glucocorticoids in the treatment of granulomatous lobular mastitis / 中国医师进修杂志

ABSTRACT

Objective To investigate the effectiveness of glucocorticoids in the treatment of granulomatous lobular mastitis (GLM), and to discuss the optimal stage to add glucocorticoids during the treatment. Methods Twenty-four patients having received the core needle biopsy were involved. Ten cases with the explicit pathological diagnosis received the glucocorticoids therapy following the subtotal excision after remission. Pathological diagnoses of the rest 14 patients were undefined. For these 14 patients, simple partial excisions were given and the postoperative pathological diagnoses were presented as the GLM. Of all the 14 patients who accepted the surgical treatment firstly, 8 patients received the postoperative glucocorticoids adjuvant therapy. For the rest 6 patients, steroid hormone therapy was not used after surgery, and they were followed up postoperatively. All patients' clinical and pathological information were collected and analyzed. Results All patients were followed up for 6-36 months (average 18) by the outpatient service. Of all the 10 patients who received the glucocorticoids therapy before surgery, only 1 patient of them got the GLM recurrence. For the 8 patients who received the postoperative glucocorticoids treatment, only 1 patient got the recurrence. For the 6 patients who received simple partial excision, the recurrence of the GLM may be up to 3. There was no statistical difference between the two groups who both received the 05). But compared with the pure surgery treatment, the difference was obviously (P<0.05). Conclusions The clinical presentation and imaging performance of GLM are unspecific, so the diagnosis of the GLM is difficult. There is no consensus regarding the optimal treatment for GLM. The glucocorticoids therapy may be necessary preoperatively or postoperatively. For the patient with clear preoperative biopsy diagnosis, preoperative glucocorticoids adjuvant chemotherapy followed by the wide excision may be an effective method.