EFFECTIVENESS OF METHOTREXATE IN THE TREATMENT OF GRANULOMATOUS MASTITIS

Background: Granulomatous mastitis is an uncommon, benign inflammatory disease of the breast. Clinically and radiologically, granulomatous mastitis can mimic a tumor. Various treatment modalities are available in clinical practice including medical and surgical interventions. Aim of the study: To assess the efficacy of the use of combined therapy of methotrexate and steroids in the management of granulomatous mastitis in whom steroid monotherapy failed or poorly responded. Patients and methods: For this retrospective study, data from 19 patients with biopsy-proven granulomatous mastitis were assessed. Demographic features clinical characteristics and course of the patients were obtained from medical records. Results: Following 3-month methotrexate therapy, 12 patients showed (63.2%) complete, 4 patients (21.1%) partial response, and the treatment had no effect in 3 patients (15.8%). No adverse effect was documented because of the methotrexate therapy. Conclusions: combination therapy of methotrexate and steroids in patients not responding to steroid monotherapy or having adverse effects should be regarded as alternative therapy instead of surgical treatment.