Assessing the efficacy of systemic and intralesional steroid in recurrent or refractory granulomatous mastitis

<b>Introduction:</b> Granulomatous mastitis (GM) is a rare chronic inflammatory breast disease, often resistant to standard treatments. The condition typically affects women of childbearing age and presents significant diagnostic and therapeutic challenges.<b>Aim:</b> This study aims to evaluate the efficacy of systemic and intralesional steroid therapies in patients with recurrent or treatment-resistant granulomatous mastitis.<b>Materials and methods:</b> This prospective, randomized controlled, single-center study was conducted at the General Surgery Clinic of Haseki Training and Research Hospital. A total of 66 patients presenting with recurrent or treatment-resistant granulomatous mastitis between June 2021 and June 2022 were included. Participants were randomly assigned to two equal groups: one group received systemic steroid therapy, and the other group received intralesional steroid therapy. Treatment responses and parameters influencing the treatment process were meticulously evaluated.<b>Results:</b> The study found that the outcomes of systemic steroid and intralesional steroid therapies were statistically similar. Additionally, statistical analysis revealed that smoking had a negative impact on treatment outcomes for both therapy methods.<b>Conclusions:</b> In patients with recurrent or treatment-resistant granulomatous mastitis, intralesional steroid therapy appears to be a viable alternative to systemic steroid therapy due to its similar statistical outcomes, ease of administration and monitoring, controlled dosage adjustments, absence of systemic side effects, and the lack of necessity for dose tapering upon discontinuation. Furthermore, to achieve optimal treatment response, it is recommended that patients cease smoking, as smoking has been found to adversely affect treatment outcomes in both therapy methods.