The role of clinical and radiological risk factors and triglyceride-glucose index in predicting recurrence of idiopathic granulomatous mastitis

Aims: Idiopathic granulomatous mastitis (IGM) is a rare breast disease characterised by granulomatous inflammation that is clinically and radiologically similar to breast cancer. The main challenge in treating IGM is the development of treatment resistance and recurrence. Many studies have been carried out in the literature to identify markers of recurrence in this disease, but no satisfactory results have been obtained. The aim of this study was to determine the role of clinical, radiological and laboratory parameters in predicting recurrence in patients with IGM and to evaluate the relationship between the triglyceride-glucose (TyG) index and IGM recurrence. Methods: In this study, the electronic medical records of 92 patients who were histopathologically diagnosed with IGM between January 2016 and February 2024 were retrospectively reviewed. Patients were divided into two groups according to recurrence status. Clinical, radiological and laboratory parameters were compared between groups. Results: Recurrence was detected in 26.1% of the patients included in the study and the average follow-up period was 27.6±4.6 months. No statistically significant difference was found between the two groups with regard to age, follow-up time, menopausal status, breastfeeding, oral contraceptive use, smoking history, parity and pathological diagnosis (p>0.05 for all). In univariate analysis, axillary lymphadenopathy, long duration of breastfeeding, low serum albumin globulin ratio and high TyG index were identified as risk factors for IGM recurrence. In multivariate regression analysis, long duration of breastfeeding (p=0.042, OR: 4.12; 95% confidence interval (CI), 1.05-16.11) and high TyG index (p=0.005, OR: 5.75; 95% confidence interval (CI), 1.69-19.54) were found to be independent risk factors for recurrence. Conclusion: Study results suggest that a high TyG index at initial presentation and long duration of breastfeeding increase the risk of recurrence in IGM patients. Therefore, questioning the breastfeeding history at the time of admission and determining and analyzing the TyG index can identify patients at high risk for recurrence.