Advances in the diagnosis and treatment of idiopathic granulomatous mastitis_West China Medical Journal

Authors：

BAI Shujing ^1,2,3 , YANG Jiqiao ^1,2 ,  YANG Xiaoqin ^1,2

1. Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Breast Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YANG Xiaoqin, Email: laurayang1977@hotmail.com

Keywords：

Idiopathic granulomatous mastitis; corticosteroids; personalized treatment; advances in diagnosis and treatment; review

DOI：

10.7507/1002-0179.202501135

Video：

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Abstract Full text Figures/Tables Video References Cited by

Idiopathic granulomatous mastitis (IGM) is a rare, chronic, benign inflammatory breast disease of unknown etiology. Diagnosis requires exclusion of other specific causes such as infectious mastitis and breast tuberculosis. There is no established consensus on optimal treatment strategies for IGM. Traditional approaches primarily involve corticosteroids, administered either orally or topically. In recent years, disease-modifying antirheumatic drugs (DMARDs) have been increasingly introduced. Surgical intervention is typically reserved for refractory cases but is associated with a high recurrence rate. Some mild cases may resolve spontaneously through conservative observation. Furthermore, personalized combination therapy has become a key focus of research. This article reviews the pathological mechanisms, clinical manifestations, diagnosis, and treatment of IGM, with a focus on analyzing the therapeutic efficacy of corticosteroids, DMARDs, antibiotics, and surgery. The aim is to provide clinicians with effective management strategies and to promote the optimization of treatment protocols and the improvement of patient prognosis.

Citation： BAI Shujing, YANG Jiqiao, YANG Xiaoqin. Advances in the diagnosis and treatment of idiopathic granulomatous mastitis. West China Medical Journal, 2026, 41(1): 142-148. doi: 10.7507/1002-0179.202501135 Copy

1.	Yuan QQ, Xiao SY, Farouk O, et al. Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition). Mil Med Res, 2022, 9(1): 20.
2.	Agrawal A, Pabolu S. A rare case of idiopathic granulomatous mastitis in a nulliparous woman with hyperprolactinemia. Cureus, 2019, 11(5): e4680.
3.	Krawczyk N, Kühn T, Ditsch N, et al. Idiopathic granulomatous mastitis as a benign condition mimicking inflammatory breast cancer: current status, knowledge gaps and rationale for the GRAMAREG Study (EUBREAST-15). Cancers (Basel), 2024, 16(19): 3387.
4.	Centers for Disease Control and Prevention (CDC). Idiopathic granulomatous mastitis in Hispanic women - Indiana, 2006-2008. MMWR Morb Mortal Wkly Rep, 2009, 58(47): 1317-1321.
5.	Uysal E, Soran A, Sezgin E, et al. Factors related to recurrence of idiopathic granulomatous mastitis: what do we learn from a multicentre study?. ANZ J Surg, 2018, 88(6): 635-639.
6.	Miller F, Seidman I, Smith CA. Granulomatous mastitis. N Y State J Med, 1971, 71(8): 2194-2195.
7.	Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol, 1972, 58(6): 642-646.
8.	Donn W, Rebbeck P, Wilson C, et al. Idiopathic granulomatous mastitis. A report of three cases and review of the literature. Arch Pathol Lab Med, 1994, 118(8): 822-825.
9.	Wijesinghe A, Lakmal K, Senevirathna J, et al. The use of intralesional corticosteroids in idiopathic granulomatous mastitis: a systematic review. Eur J Breast Health, 2024, 20(4): 233-240.
10.	Akbulut S, Yilmaz D, Bakir S. Methotrexate in the management of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases. Breast J, 2011, 17(6): 661-668.
11.	Davis J, Cocco D, Matz S, et al. Re-evaluating if observation continues to be the best management of idiopathic granulomatous mastitis. Surgery, 2019, 166(6): 1176-1180.
12.	Liu R, Luo Z, Dai C, et al. Corynebacterium parakroppenstedtiisecretes a novel glycolipid to promote the development of granulomatous lobular mastitis. Signal Transduct Target Ther, 2024, 9(1): 292.
13.	宿琦琦, 劉曉菲, 李書園, 等. 特發性肉芽腫乳腺炎診療研究進展. 中國現代普通外科進展, 2023, 26(6): 489-492.
14.	Benson JR, Dumitru D. Idiopathic granulomatous mastitis: presentation, investigation and management. Future Oncol, 2016, 12(11): 1381-1394.
15.	Velidedeo?lu M, Papila Kundaktepe B, Mete B, et al. Idiopathic granulomatous mastitis associated with erythema nodosum may indicate a worse prognosis. Int J Rheum Dis, 2021, 24(11): 1370-1377.
16.	Deng JQ, Yu L, Yang Y, et al. Steroids administered after vacuum-assisted biopsy in the management of idiopathic granulomatous mastitis. J Clin Pathol, 2017, 70(10): 827-831.
17.	Emsen A, K?ksal H, U?ary?lmaz H, et al. The alteration of lymphocyte subsets in idiopathic granulomatous mastitis. Turk J Med Sci, 2021, 51(4): 1905-1911.
18.	Li F, Nie L, Huang J, et al. Evaluation of significantly changed chemokine factors of idiopathic granulomatous mastitis in non-puerperal patients. FASEB J, 2024, 38(13): e23745.
19.	Koksal H, Vatansev H, Artac H, et al. The clinical value of interleukins-8, -10, and -17 in idiopathic granulomatous mastitis. Clin Rheumatol, 2020, 39(5): 1671-1677.
20.	Saydam M, Yilmaz KB, Sahin M, et al. New findings on autoimmune etiology of idiopathic granulomatous mastitis: serum IL-17, IL-22 and IL-23 levels of patients. J Invest Surg, 2021, 34(9): 993-997.
21.	Huang YM, Lo C, Cheng CF, et al. Serum C-reactive protein and interleukin-6 levels as biomarkers for disease severity and clinical outcomes in patients with idiopathic granulomatous mastitis. J Clin Med, 2021, 10(10): 2077.
22.	Wang X, He X, Liu J, et al. Immune pathogenesis of idiopathic granulomatous mastitis: from etiology toward therapeutic approaches. Front Immunol, 2024, 15: 1295759.
23.	Yin Y, Liu X, Meng Q, et al. Idiopathic granulomatous mastitis: etiology, clinical manifestation, diagnosis and treatment. J Invest Surg, 2022, 35(3): 709-720.
24.	Taylor GB, Paviour SD, Musaad S, et al. A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology, 2003, 35(2): 109-119.
25.	Ong SS, Xu J, Sim CK, et al. Profiling microbial communities in idiopathic granulomatous mastitis. Int J Mol Sci, 2023, 24(2): 1042.
26.	Ang LM, Brown H. Corynebacterium accolens isolated from breast abscess: possible association with granulomatous mastitis. J Clin Microbiol, 2007, 45(5): 1666-1668.
27.	Paviour S, Musaad S, Roberts S, et al. Corynebacterium species isolated from patients with mastitis. Clin Infect Dis, 2002, 35(11): 1434-1440.
28.	Chen W, Zhang D, Zeng Y, et al. Clinical characteristics and microbiota analysis of 44 patients with granulomatous mastitis. Front Microbiol, 2023, 14: 1175206.
29.	Li XQ, Wu HL, Yuan JP, et al. Bacteria associated with granulomatous lobular mastitis and the potential for personalized therapy. J Invest Surg, 2022, 35(1): 164-170.
30.	中華醫學會神經外科學分會, 中華醫學會婦產科學分會, 中華醫學會內分泌學分會. 高催乳素血癥診療共識. 中華醫學雜志, 2011, 91(3): 147-154.
31.	Borba VV, Zandman-Goddard G, Shoenfeld Y. Prolactin and autoimmunity: the hormone as an inflammatory cytokine. Best Pract Res Clin Endocrinol Metab, 2019, 33(6): 101324.
32.	中華醫學會病理學分會, 中國抗癌協會腫瘤病理專業委員會乳腺腫瘤學組. 肉芽腫性小葉性乳腺炎病理診斷中國專家共識(2024 版). 中華病理學雜志, 2024, 53(10): 996-1004.
33.	Boldrini C. Granulomatous mastitis (GM) in a young woman with a previous history of prolactin-secreting PitNET and actual normal prolactinemia. Radiol Case Rep, 2023, 18(2): 550-555.
34.	?etin K. Breastfeeding and secretory factors in idiopathic granulomatous mastitis: unveiling etiological insights. World J Surg, 2025, 49(1): 15-23.
35.	Tang ELS, Ho CSB, Chan PMY, et al. The therapeutic dilemma of idiopathic granulomatous mastitis. Ann Acad Med Singap, 2021, 50(8): 598-605.
36.	Lin CH, Hsu CW, Tsao TY, et al. Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia. Diagn Pathol, 2012, 7: 2.
37.	Naraynsingh V, Hariharan S, Dan D, et al. Conservative management for idiopathic granulomatous mastitis mimicking carcinoma: case reports and literature review. Breast Dis, 2010, 31(1): 57-60.
38.	Alsaleh N. Assertive clinical practice in managing patients with idiopathic granulomatous mastitis: review of literature. Ann Med Surg (Lond), 2021, 70: 102792.
39.	Grover H, Grover SB, Goyal P, et al. Clinical and imaging features of idiopathic granulomatous mastitis—The diagnostic challenges and a brief review. Clin Imaging, 2021, 69: 126-132.
40.	Alikhassi A, Azizi F, Ensani F. Imaging features of granulomatous mastitis in 36 patients with new sonographic signs. J Ultrasound, 2020, 23(1): 61-68.
41.	Chen X, Huang H, Huang H, et al. Ductal lavage followed by observation versus oral corticosteroids in idiopathic granulomatous mastitis: a randomized trial. Nat Commun, 2024, 15(1): 9144.
42.	Jiao Y, Chang K, Jiang Y, et al. Identification of periductal mastitis and granulomatous lobular mastitis: a literature review. Ann Transl Med, 2023, 11(3): 158.
43.	Cui L, Sun C, Guo J, et al. Pathological manifestations of granulomatous lobular mastitis. Front Med (Lausanne), 2024, 11: 1326587.
44.	Haddad M, Sheybani F, Arian M, et al. Methotrexate-based regimen as initial treatment of patients with idiopathic granulomatous mastitis. Breast J, 2020, 26(2): 325-327.
45.	Zhou F, Shang XC, Tian XS, et al. Clinical practice guidelines for diagnosis and treatment of patients with non-puerperal mastitis: Chinese Society of Breast Surgery (CSBrS) practice guideline 2021. Chin Med J (Engl), 2021, 134(15): 1765-1767.
46.	Tan QW, Zhang YN, Jia YP, et al. Methylprednisolone for idiopathic granulomatous mastitis: a prospective observational cohort study. Gland Surg, 2022, 11(9): 1538-1545.
47.	Toktas O, Konca C, Trabulus DC, et al. A novel first-line treatment alternative for noncomplicated idiopathic granulomatous mastitis: combined intralesional steroid injection with topical steroid administration. Breast Care (Basel), 2021, 16(2): 181-187.
48.	Zhang Q, Zhang W, Lv J, et al. The effect of local steroid administration on idiopathic granulomatous mastitis: a systematic review and meta-analysis. J Surg Res, 2024, 295: 511-521.
49.	?etin K, Sikar HE, G?ret NE, et al. Comparison of topical, systemic, and combined therapy with steroids on idiopathic granulomatous mastitis: a prospective randomized study. World J Surg, 2019, 43(11): 2865-2873.
50.	Parperis K, Costi E, Philippou S, et al. Efficacy of disease-modifying antirheumatic drugs in the treatment of granulomatous mastitis: a systematic review. Rheumatol Int, 2024, 44(11): 2371-2379.
51.	Ringsted S, Friedman M. A rheumatologic approach to granulomatous mastitis: a case series and review of the literature. Int J Rheum Dis, 2021, 24(4): 526-532.
52.	Kaya MN, Tekg?z E, ?olak S, et al. Five-year follow-up of idiopathic granulomatous mastitis. Ir J Med Sci, 2025, 194(1): 271-276.
53.	Joseph KA, Luu X, Mor A. Granulomatous mastitis: a New York public hospital experience. Ann Surg Oncol, 2014, 21(13): 4159-4163.
54.	Williams MS, McClintock AH, Bourassa L, et al. Treatment of granulomatous mastitis: is there a role for antibiotics?. Eur J Breast Health, 2021, 17(3): 239-246.
55.	Tan QT, Tay SP, Gudi MA, et al. Granulomatous mastitis and factors associated with recurrence: an 11-year single-centre study of 113 patients in singapore. World J Surg, 2019, 43(7): 1737-1745.
56.	Samsami M, Parsaeian F, Haghbin Toutounchi A, et al. The impact of cotrimoxazole in idiopathic granulomatous mastitis treatment. Int J Surg Case Rep, 2024, 121: 109959.
57.	孫巖峰, 王永, 李玉勝, 等. 特發性肉芽腫性乳腺炎的診療進展. 中華乳腺病雜志(電子版), 2017, 11(6): 372-374.
58.	Fattahi AS, Amini G, Sajedi F, et al. Factors affecting recurrence of idiopathic granulomatous mastitis: a systematic review. Breast J, 2023, 2023: 9947797.
59.	Lei X, Chen K, Zhu L, et al. Treatments for idiopathic granulomatous mastitis: systematic review and meta-analysis. Breastfeed Med, 2017, 12(7): 415-421.
60.	Ma X, Min X, Yao C. Different treatments for granulomatous lobular mastitis: a systematic review and meta-analysis. Breast Care (Basel), 2020, 15(1): 60-66.
61.	司徒紅林, 井含光, 劉暢, 等. 林毅運用“燮理陰陽, 立法衡通”中醫綜合療法辨治肉芽腫性乳腺炎. 廣州中醫藥大學學報, 2020, 37(10): 1999-2003.
62.	朱晴, 劉曉菲, 王楠, 等. 宋愛莉教授治療肉芽腫性乳腺炎經驗拾要. 亞太傳統醫藥, 2019, 15(3): 87-89.
63.	Ong SS, Ho PJ, Liow JJK, et al. A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention. Front Med (Lausanne), 2024, 11: 1346790.
64.	Shojaeian F, Haghighat S, Abbasvandi F, et al. Refractory and recurrent idiopathic granulomatous mastitis treatment: adaptive, randomized clinical trial. J Am Coll Surg, 2024, 238(6): 1153-1165.
65.	Kehribar DY, Duran TI, Polat AK, et al. Effectiveness of methotrexate in idiopathic granulomatous mastitis treatment. Am J Med Sci, 2020, 360(5): 560-565.

1. Yuan QQ, Xiao SY, Farouk O, et al. Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition). Mil Med Res, 2022, 9(1): 20.
2. Agrawal A, Pabolu S. A rare case of idiopathic granulomatous mastitis in a nulliparous woman with hyperprolactinemia. Cureus, 2019, 11(5): e4680.
3. Krawczyk N, Kühn T, Ditsch N, et al. Idiopathic granulomatous mastitis as a benign condition mimicking inflammatory breast cancer: current status, knowledge gaps and rationale for the GRAMAREG Study (EUBREAST-15). Cancers (Basel), 2024, 16(19): 3387.
4. Centers for Disease Control and Prevention (CDC). Idiopathic granulomatous mastitis in Hispanic women - Indiana, 2006-2008. MMWR Morb Mortal Wkly Rep, 2009, 58(47): 1317-1321.
5. Uysal E, Soran A, Sezgin E, et al. Factors related to recurrence of idiopathic granulomatous mastitis: what do we learn from a multicentre study?. ANZ J Surg, 2018, 88(6): 635-639.
6. Miller F, Seidman I, Smith CA. Granulomatous mastitis. N Y State J Med, 1971, 71(8): 2194-2195.
7. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol, 1972, 58(6): 642-646.
8. Donn W, Rebbeck P, Wilson C, et al. Idiopathic granulomatous mastitis. A report of three cases and review of the literature. Arch Pathol Lab Med, 1994, 118(8): 822-825.
9. Wijesinghe A, Lakmal K, Senevirathna J, et al. The use of intralesional corticosteroids in idiopathic granulomatous mastitis: a systematic review. Eur J Breast Health, 2024, 20(4): 233-240.
10. Akbulut S, Yilmaz D, Bakir S. Methotrexate in the management of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases. Breast J, 2011, 17(6): 661-668.
11. Davis J, Cocco D, Matz S, et al. Re-evaluating if observation continues to be the best management of idiopathic granulomatous mastitis. Surgery, 2019, 166(6): 1176-1180.
12. Liu R, Luo Z, Dai C, et al. Corynebacterium parakroppenstedtiisecretes a novel glycolipid to promote the development of granulomatous lobular mastitis. Signal Transduct Target Ther, 2024, 9(1): 292.
13. 宿琦琦, 劉曉菲, 李書園, 等. 特發性肉芽腫乳腺炎診療研究進展. 中國現代普通外科進展, 2023, 26(6): 489-492.
14. Benson JR, Dumitru D. Idiopathic granulomatous mastitis: presentation, investigation and management. Future Oncol, 2016, 12(11): 1381-1394.
15. Velidedeo?lu M, Papila Kundaktepe B, Mete B, et al. Idiopathic granulomatous mastitis associated with erythema nodosum may indicate a worse prognosis. Int J Rheum Dis, 2021, 24(11): 1370-1377.
16. Deng JQ, Yu L, Yang Y, et al. Steroids administered after vacuum-assisted biopsy in the management of idiopathic granulomatous mastitis. J Clin Pathol, 2017, 70(10): 827-831.
17. Emsen A, K?ksal H, U?ary?lmaz H, et al. The alteration of lymphocyte subsets in idiopathic granulomatous mastitis. Turk J Med Sci, 2021, 51(4): 1905-1911.
18. Li F, Nie L, Huang J, et al. Evaluation of significantly changed chemokine factors of idiopathic granulomatous mastitis in non-puerperal patients. FASEB J, 2024, 38(13): e23745.
19. Koksal H, Vatansev H, Artac H, et al. The clinical value of interleukins-8, -10, and -17 in idiopathic granulomatous mastitis. Clin Rheumatol, 2020, 39(5): 1671-1677.
20. Saydam M, Yilmaz KB, Sahin M, et al. New findings on autoimmune etiology of idiopathic granulomatous mastitis: serum IL-17, IL-22 and IL-23 levels of patients. J Invest Surg, 2021, 34(9): 993-997.
21. Huang YM, Lo C, Cheng CF, et al. Serum C-reactive protein and interleukin-6 levels as biomarkers for disease severity and clinical outcomes in patients with idiopathic granulomatous mastitis. J Clin Med, 2021, 10(10): 2077.
22. Wang X, He X, Liu J, et al. Immune pathogenesis of idiopathic granulomatous mastitis: from etiology toward therapeutic approaches. Front Immunol, 2024, 15: 1295759.
23. Yin Y, Liu X, Meng Q, et al. Idiopathic granulomatous mastitis: etiology, clinical manifestation, diagnosis and treatment. J Invest Surg, 2022, 35(3): 709-720.
24. Taylor GB, Paviour SD, Musaad S, et al. A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology, 2003, 35(2): 109-119.
25. Ong SS, Xu J, Sim CK, et al. Profiling microbial communities in idiopathic granulomatous mastitis. Int J Mol Sci, 2023, 24(2): 1042.
26. Ang LM, Brown H. Corynebacterium accolens isolated from breast abscess: possible association with granulomatous mastitis. J Clin Microbiol, 2007, 45(5): 1666-1668.
27. Paviour S, Musaad S, Roberts S, et al. Corynebacterium species isolated from patients with mastitis. Clin Infect Dis, 2002, 35(11): 1434-1440.
28. Chen W, Zhang D, Zeng Y, et al. Clinical characteristics and microbiota analysis of 44 patients with granulomatous mastitis. Front Microbiol, 2023, 14: 1175206.
29. Li XQ, Wu HL, Yuan JP, et al. Bacteria associated with granulomatous lobular mastitis and the potential for personalized therapy. J Invest Surg, 2022, 35(1): 164-170.
30. 中華醫學會神經外科學分會, 中華醫學會婦產科學分會, 中華醫學會內分泌學分會. 高催乳素血癥診療共識. 中華醫學雜志, 2011, 91(3): 147-154.
31. Borba VV, Zandman-Goddard G, Shoenfeld Y. Prolactin and autoimmunity: the hormone as an inflammatory cytokine. Best Pract Res Clin Endocrinol Metab, 2019, 33(6): 101324.
32. 中華醫學會病理學分會, 中國抗癌協會腫瘤病理專業委員會乳腺腫瘤學組. 肉芽腫性小葉性乳腺炎病理診斷中國專家共識(2024 版). 中華病理學雜志, 2024, 53(10): 996-1004.
33. Boldrini C. Granulomatous mastitis (GM) in a young woman with a previous history of prolactin-secreting PitNET and actual normal prolactinemia. Radiol Case Rep, 2023, 18(2): 550-555.
34. ?etin K. Breastfeeding and secretory factors in idiopathic granulomatous mastitis: unveiling etiological insights. World J Surg, 2025, 49(1): 15-23.
35. Tang ELS, Ho CSB, Chan PMY, et al. The therapeutic dilemma of idiopathic granulomatous mastitis. Ann Acad Med Singap, 2021, 50(8): 598-605.
36. Lin CH, Hsu CW, Tsao TY, et al. Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia. Diagn Pathol, 2012, 7: 2.
37. Naraynsingh V, Hariharan S, Dan D, et al. Conservative management for idiopathic granulomatous mastitis mimicking carcinoma: case reports and literature review. Breast Dis, 2010, 31(1): 57-60.
38. Alsaleh N. Assertive clinical practice in managing patients with idiopathic granulomatous mastitis: review of literature. Ann Med Surg (Lond), 2021, 70: 102792.
39. Grover H, Grover SB, Goyal P, et al. Clinical and imaging features of idiopathic granulomatous mastitis—The diagnostic challenges and a brief review. Clin Imaging, 2021, 69: 126-132.
40. Alikhassi A, Azizi F, Ensani F. Imaging features of granulomatous mastitis in 36 patients with new sonographic signs. J Ultrasound, 2020, 23(1): 61-68.
41. Chen X, Huang H, Huang H, et al. Ductal lavage followed by observation versus oral corticosteroids in idiopathic granulomatous mastitis: a randomized trial. Nat Commun, 2024, 15(1): 9144.
42. Jiao Y, Chang K, Jiang Y, et al. Identification of periductal mastitis and granulomatous lobular mastitis: a literature review. Ann Transl Med, 2023, 11(3): 158.
43. Cui L, Sun C, Guo J, et al. Pathological manifestations of granulomatous lobular mastitis. Front Med (Lausanne), 2024, 11: 1326587.
44. Haddad M, Sheybani F, Arian M, et al. Methotrexate-based regimen as initial treatment of patients with idiopathic granulomatous mastitis. Breast J, 2020, 26(2): 325-327.
45. Zhou F, Shang XC, Tian XS, et al. Clinical practice guidelines for diagnosis and treatment of patients with non-puerperal mastitis: Chinese Society of Breast Surgery (CSBrS) practice guideline 2021. Chin Med J (Engl), 2021, 134(15): 1765-1767.
46. Tan QW, Zhang YN, Jia YP, et al. Methylprednisolone for idiopathic granulomatous mastitis: a prospective observational cohort study. Gland Surg, 2022, 11(9): 1538-1545.
47. Toktas O, Konca C, Trabulus DC, et al. A novel first-line treatment alternative for noncomplicated idiopathic granulomatous mastitis: combined intralesional steroid injection with topical steroid administration. Breast Care (Basel), 2021, 16(2): 181-187.
48. Zhang Q, Zhang W, Lv J, et al. The effect of local steroid administration on idiopathic granulomatous mastitis: a systematic review and meta-analysis. J Surg Res, 2024, 295: 511-521.
49. ?etin K, Sikar HE, G?ret NE, et al. Comparison of topical, systemic, and combined therapy with steroids on idiopathic granulomatous mastitis: a prospective randomized study. World J Surg, 2019, 43(11): 2865-2873.
50. Parperis K, Costi E, Philippou S, et al. Efficacy of disease-modifying antirheumatic drugs in the treatment of granulomatous mastitis: a systematic review. Rheumatol Int, 2024, 44(11): 2371-2379.
51. Ringsted S, Friedman M. A rheumatologic approach to granulomatous mastitis: a case series and review of the literature. Int J Rheum Dis, 2021, 24(4): 526-532.
52. Kaya MN, Tekg?z E, ?olak S, et al. Five-year follow-up of idiopathic granulomatous mastitis. Ir J Med Sci, 2025, 194(1): 271-276.
53. Joseph KA, Luu X, Mor A. Granulomatous mastitis: a New York public hospital experience. Ann Surg Oncol, 2014, 21(13): 4159-4163.
54. Williams MS, McClintock AH, Bourassa L, et al. Treatment of granulomatous mastitis: is there a role for antibiotics?. Eur J Breast Health, 2021, 17(3): 239-246.
55. Tan QT, Tay SP, Gudi MA, et al. Granulomatous mastitis and factors associated with recurrence: an 11-year single-centre study of 113 patients in singapore. World J Surg, 2019, 43(7): 1737-1745.
56. Samsami M, Parsaeian F, Haghbin Toutounchi A, et al. The impact of cotrimoxazole in idiopathic granulomatous mastitis treatment. Int J Surg Case Rep, 2024, 121: 109959.
57. 孫巖峰, 王永, 李玉勝, 等. 特發性肉芽腫性乳腺炎的診療進展. 中華乳腺病雜志(電子版), 2017, 11(6): 372-374.
58. Fattahi AS, Amini G, Sajedi F, et al. Factors affecting recurrence of idiopathic granulomatous mastitis: a systematic review. Breast J, 2023, 2023: 9947797.
59. Lei X, Chen K, Zhu L, et al. Treatments for idiopathic granulomatous mastitis: systematic review and meta-analysis. Breastfeed Med, 2017, 12(7): 415-421.
60. Ma X, Min X, Yao C. Different treatments for granulomatous lobular mastitis: a systematic review and meta-analysis. Breast Care (Basel), 2020, 15(1): 60-66.
61. 司徒紅林, 井含光, 劉暢, 等. 林毅運用“燮理陰陽, 立法衡通”中醫綜合療法辨治肉芽腫性乳腺炎. 廣州中醫藥大學學報, 2020, 37(10): 1999-2003.
62. 朱晴, 劉曉菲, 王楠, 等. 宋愛莉教授治療肉芽腫性乳腺炎經驗拾要. 亞太傳統醫藥, 2019, 15(3): 87-89.
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West China Medical Journal

Advances in the diagnosis and treatment of idiopathic granulomatous mastitis

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