Long-Term Outcomes of Traditional Chinese Medicine in the Treatment of Granulomatous Lobular Mastitis: A Two-Year Follow-Up Study on Recurrence and New Occurrence Rates with Analysis of Risk Factors

Abstract

Background: Patients with clinically cured granulomatous lobular mastitis (GLM) still face a high probability of recurrence and new occurrence.

Purpose: To evaluate the long-term efficacy of traditional Chinese medicine (TCM) in treating GLM and to hypothesize potential risk factors for recurrence or new occurrence.

Patients and methods: A retrospective analysis was conducted on GLM patients treated with TCM at Longhua Hospital affiliated with Shanghai University of Traditional Chinese Medicine from January 2016 to July 2021. We analyzed general data, two-year recurrence and new occurrence rates, and 12 risk factors associated with recurrence or new occurrence.

Results: This cross-sectional study included 261 GLM patients with an average age at onset of 31.95 years (primarily aged 31-40). The two-year recurrence rate for GLM was 1.53%, and the new occurrence rate was 4.21%. Univariate and multivariate conditional logistic regression analyses revealed that a history of inverted nipples was associated with the risk of both recurrence and new occurrence of GLM (HR = 8.672, 5.375, P < 0.05), and menstrual irregularity was related to a higher risk of recurrence (HR = 13.172, P < 0.001).

Conclusion: A history of inverted nipples is identified as a potential risk factor associated with the long-term recurrence and new occurrence of GLM, while menstrual irregularity is associated with recurrence. Despite this, patients with GLM undergoing TCM demonstrate low rates of long-term recurrence and new occurrence after achieving clinical cure, underscoring the effectiveness of TCM. This study lays the groundwork for a long-term effectiveness strategy to guide future GLM treatments.

Keywords: GLM; granulomatous lobular mastitis; new occurrence; recurrence; risk factor.

Figure 1

Flow chart of the study.

Figure 2

The recurrence and new occurrence rate of clinical cure GLM patients who received TCM treatment (A), the two-year recurrence and new occurrence rates of patients with GLM (blue) (B), the recurrence-free survival probability (C) and the new occurrence-free survival probability (D) of GLM patients after clinical recovery within two years.