title: Comparison of the effect of surgical and medical therapy for the treatment of idiopathic granulomatous mastitis.
abstract: BACKGROUND
  Idiopathic granulomatous mastitis (IGM) is defined as a rare, inflammatory, chronic and benign disease mimicking malignant hyperplasia of mammary glands. There is no definitive therapeutic strategy for IGM; nevertheless, some approaches can be exploited as beneficial strategies. In this study, the surgery strategy was compared with coincident treatment with azithromycin and corticosteroid in IGM patients.
  
  
  METHODS
  This study was implemented as clinical trial during 2011-2013 in Isfahan, Iran. The target population comprised women whose IGM was substantiated. The medical group consisted of 20 patients, which were compared with a historical control group treated through surgical approach. Surgical group comprised 39 patients. Partial mastectomy was implemented in the surgical group whereas treatment protocol comprising azithromycin and prednisolone administered in medical group. Recurrence of mass was followed for 12 months. Fischer exact test, Chi-square test, Mann-Whitney and regression tests were applied for statistical analysis. This study was registered in Iranian Registry of clinical trial (IRCT number: IRCT 2013123015999N1).
  
  
  RESULTS
  No significant differences were recognized in side of lesions, lymphadenopathy, fever and pain; however, number of abscesses, number of lesions and size of lesions were significantly higher in the surgical group (P < 0.0001). Furthermore, probability of relapse correlated with the number of lesions, (odds ratio = 24.67 confidence interval [CI] = 2.2-269.3), whereas methods of IGM treatment did not contribute to the likelihood of relapse (odds ratio = 12.5 CI = 0.52-299).
  
  
  CONCLUSIONS
  This clinical trial demonstrated that pharmaceutical treatment has appropriate efficacy, in treatment and prevention of IGM relapse. Moreover, this study presented hazf gardad number of the lesions as the most appropriate criteria for IGM prognosis, thus the probability of relapse decreases whether earlier IGM recognizing could be implemented.
authors.affiliation: Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Salehi
authors.affiliation: Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Salehi
authors.affiliation: Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Moafi
authors.affiliation: Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Taleban
authors.affiliation: Department of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Seyed Abass
authors.initials: SA
authors.lastname: Tabatabaei
authors.affiliation: Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Salehi
authors.affiliation: Department of Infectious Diseases, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohammad-Mahdi
authors.initials: MM
authors.lastname: Salehi
keywords: Azithromycin; breast disease; idiopathic granulomatous mastitis; mastectomy; steroids