用类固醇治疗肉芽肿性乳腺炎:是否应通过放射学方法决定是否终止治疗?

IF 1.3 Q4 ONCOLOGY
European journal of breast health Pub Date : 2023-12-27 eCollection Date: 2024-01-01 DOI:10.4274/ejbh.galenos.2023.2023-9-2
Kenan Çetin, Hasan Ediz Sıkar, Fatih Feratoğlu, Bağış Taşdoğan, Bahadır M Güllüoğlu
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引用次数: 0

摘要

目的:特发性肉芽肿性乳腺炎(IGM特发性肉芽肿性乳腺炎(IGM)是一种病因不明的良性乳腺炎症,多发于生育期妇女。最常用的一线治疗方案是类固醇激素,但由于缺乏标准治疗方案,且治疗后复发率较高,因此在治疗过程中经常面临挑战。本研究的目的是探讨应通过放射学还是临床来决定是否结束治疗:这项回顾性队列研究纳入了接受类固醇治疗后临床完全康复并接受至少 30 个月随访的 IGM 患者。研究评估了患者的人口统计学特征、疾病严重程度和检查结果、治疗方案和持续时间以及临床康复时的磁共振成像(MRI)检查结果与复发的关系:研究共纳入了89例经类固醇治疗后临床完全痊愈的IGM患者。在临床痊愈时,51 例(57.3%)患者的核磁共振检查结果为完全放射学反应,38 例(42.7%)患者的核磁共振检查结果为部分放射学反应(PRR)。中位随访 38.6 个月后,22 例(24.7%)患者复发。出现复发的患者年龄明显偏大,并且在临床痊愈后停止治疗时出现了PRR:结论:在临床痊愈的过程中,影像学检查结果显示,残留病灶似乎是预测 IGM 患者复发的一个重要因素。对于有 PRR 的患者,延长类固醇治疗时间或通过手术切除隐性残留病灶可防止 IGM 患者复发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment of Granulomatous Mastitis With Steroids: Should the Decision to End the Treatment be Made Radiologically?

Objective: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory breast disease of unknown etiology that affects women in their reproductive period. The most commonly preferred option as first-line treatment is steroids, but the lack of a standard treatment protocol and high recurrence rate after treatment constitutes a recurring challenge during its management. The aim of this study was to investigate whether the decision to end the treatment should be made radiologically or clinically.

Materials and methods: This retrospective cohort study included IGM patients who had complete clinical recovery with steroids and were followed for a minimum of 30 months. Patient demographics, disease severity and findings, treatment regimens and duration, and magnetic resonance imaging (MRI) findings at clinical recovery were assessed for their relation to recurrence.

Results: Eighty-nine patients who were clinically completely healed after steroid treatment for IGM were included in the study. At the time of clinical healing, 51 (57.3%) patients had a complete radiological response and 38 (42.7%) had a partial radiological response (PRR) on MRI. Overall, recurrence developed in 22 (24.7%) patients after a median 38.6-month follow-up. Patients who experienced recurrence were significantly older and had PRR when their treatment was stopped upon clinical healing.

Conclusion: During the process of clinical healing, the imaging findings revealed that the remaining disease seems to be a significant predictor for recurrence in IGM patients. In patients with PRR, extending the treatment with either prolonged steroid therapy or by surgical excision of the occult residual disease may prevent recurrences in IGM patients.

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