ArticleThe breast journal2026
Treatment Outcomes of Lobular Granulomatous Mastitis: Impact of Hyperprolactinemia, Diabetes, and Erythema Nodosum-Insights From a 7-Year Cohort Study.
Article in The breast journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Case Report: Staged topical herbal therapy for giant plasma cell mastitis in pregnancy with 3-year follow-up.Frontiers in medicine · 2026Article
- Treatment Outcomes of Lobular Granulomatous Mastitis: Impact of Hyperprolactinemia, Diabetes, and Erythema Nodosum-Insights From a 7-Year Cohort Study.The breast journal · 2026Article
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8 authors.
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Abstract
backgroundThis study presents our observations on the management and follow-up of patients diagnosed with lobular granulomatous mastitis (LGM) in a cohort study. Additionally, characteristics associated with a longer disease course, as well as treatment challenges in patients with erythema nodosum, diabetes, and hyperprolactinemia, would be discussed.
methodsFrom 2015 to 2021, a total of 246 consecutive LGM patients referred to the internal medicine clinic of Ghaem teaching hospital, Mashhad, Iran, were enrolled. Regular assessments were conducted every 3 months until complete symptom resolution. Treatment responses were categorized into five groups: complete resolution, incomplete resolution, resolution with subsequent relapse, no significant improvement, and treatment cessation, with all data meticulously recorded. Telephone follow-ups were conducted with all patients at the end of the study in December 2022.
resultsA total of 156 episodes were analyzed. Prednisone was administered to 136 patients, while oral methotrexate (MTX) was prescribed to 48 cases. The median age of the cohort was 33 years (interquartile range [IQR], 29-38). Of those on prednisone, 57 (41.9%) achieved complete resolution, with 15 (11%) experiencing subsequent relapse, 33 (24.3%) showing no significant improvement, and 31 (19.9%) discontinuing treatment. Among the MTX recipients, 23 (47.9%) achieved complete resolution, while one showed incomplete resolution. Over the median follow-up of five years (IQR, 4-6), 139 (89.1%) reported complete resolution, nine (5.8%) showed incomplete resolution, and 8 (5.1%) remained symptomatic. The median disease duration was 18 months (IQR, 7-36). Abscess formation during treatment correlated with prolonged disease duration (p < 0.04), and higher plasma prolactin levels were associated with extended disease duration (p = 0.001). However, the disease course did not significantly differ in diabetic cases or those with erythema nodosum compared to others.
conclusionsAlthough more than half of LGM patients experienced no significant improvement, recurrence, or discontinued treatment on prednisone or MTX, however, over a median follow-up of 5 years, approximately 90% of LGM patients achieved complete resolution within a median course of 18 months. The presence of abscesses during treatment and elevated plasma prolactin levels was linked to longer disease duration.
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