Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov;44(11):2371-2379.
doi: 10.1007/s00296-024-05719-w. Epub 2024 Sep 16.

>Efficacy of disease-modifying antirheumatic drugs in the treatment of granulomatous mastitis: a systematic review

Konstantinos Parperis  1   2 , Egli Costi  3 , Sofia Philippou  3 , Mohanad Hadi  4 , Chris T Derk  3   5
Affiliations

>Efficacy of disease-modifying antirheumatic drugs in the treatment of granulomatous mastitis: a systematic review

Konstantinos Parperis et al. Rheumatol Int. 2024 Nov.

Abstract

Introduction: Idiopathic granulomatous mastitis (IGM) is an inflammatory breast disorder of unknown etiology. This benign condition can mimic the clinical presentation of breast cancer and is characterized by symptoms such as breast pain, erythema, and swelling. Over the past few years, Disease-Modifying Antirheumatic Drugs (DMARDs) have been increasingly used to manage this condition. However, strong evidence to support their use is lacking.

Objectives: This systematic review aimed to summarize the evidence and evaluate the efficacy of DMARDs in the management of IGM.

Methods: A systematic literature review, adhering to PRISMA guidelines, was conducted across electronic databases, including PubMed, EMBASE, SCOPUS, directory of open access journals (DOAJ) and Cochrane Library from their inception until May 2024. We included retrospective and prospective studies while excluding case reports and case series of less than 10 patients.

Results: Eighteen studies met our eligibility criteria. Fifteen studies were retrospective, while 2 were prospective. No randomized controlled trials were identified. Of these, 16 papers examined the effect of methotrexate on IGM, revealing significant disease improvement in most cases. Several of the studies indicated that patients treated with azathioprine and mycophenolate mofetil also achieved favorable responses.

Conclusion: Given the rarity of IGM, only a limited number of studies have explored the use of DMARDs as a pharmacological treatment option. A significant barrier to advancing our understanding is the substantial heterogeneity in the quality and volume of data provided by these studies. Therefore, there is a need for well-designed, randomized, placebo-controlled trials to rigorously assess the efficacy of DMARDs in the treatment of IGM.

Keywords: Disease management; Disease-modifying antirheumatic drugs (DMARDs); Granulomatous mastitis (GM).

PubMed Disclaimer

References

    1. Kessler E, Wolloch Y (1972) Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 58(6):642–646. https://doi.org/10.1093/ajcp/58.6.642 - DOI - PubMed
    1. Freeman CM, Lewis JD, Lower EE, Khan S, Shaughnessy E (2014) Refractory granulomas of breast: Benign or malignant disease. J Clin Oncol 32(26suppl):21–21. https://doi.org/10.1200/jco.2014.32.26_suppl.21 - DOI
    1. Barreto DS, Sedgwick EL, Nagi C, Benveniste AP (2018) Granulomatous mastitis: etiology, imaging, pathology, treatment, and clinical findings. Breast Cancer Res Treat 171(3):527–534. https://doi.org/10.1007/s10549-018-4870-3 - DOI - PubMed
    1. Kawashima K, Yamamoto S, Narui K, Fujiwara Y, Adachi S, Sasamoto M et al (2023) Granulomatous mastitis in a male breast: a case report and review of literature. Clin Case Rep 11(3). https://doi.org/10.1002/ccr3.7048
    1. Centers for Disease Control and Prevention (CDC). Idiopathic granulomatous mastitis in Hispanic women -- Indiana, 2006–2008. | MMWR: Morbidity & Mortality Weekly Report | EBSCOhost [Internet] (2009) https://openurl.ebsco.com/EPDB%3Agcd%3A15%3A8667999/detailv2?sid=ebsco%3...

Publication types

LinkOut - more resources