Observation on the Timing and Efficacy of Methylprednisolone Combined with Methotrexate in the Treatment of Recurrent Granulomatous Mastitis

WU Mengqi; TAN Jichao; SHE Qing; CHEN Yuanyuan; LI Youhuai

doi:10.14033/j.cnki.cfmr.2025.15.001

Abstract：Objective:To investigate the efficacy of methylprednisolone combined with methotrexate at different times in the treatment of recurrent granulomatous mastitis(RGLM).Method:Thirty-nine patients with recurrent mastitis was diagnosed as granulomatous mastitis by pathology admitted to Baoji Central Hospital from January 2024 to August 2024 were selected as the study objects.The therapeutic efficacy of methylpredone combined with methotrexate and the efficacy before and after adding methotrexate in different cycles were compared,and adverse reactions and clinical recurrence rates of patients were observed after follow-up.Result:After treatment,6 cases were cured,27 cases were effective and 6 cases were ineffective.The total effective rate was 84.62%.The total effective rate of methotrexate was 87.50%at the 2nd week,100.00%at the 4th week,and 50.00%at the 6th week.There were significant differences in the efficacy of methotrexate at different periods,and the difference was statistically significant(P<0.05).After methylprednisolone treatment,the tumor size and the degree of inflammation and infection changed significantly before and after methotrexate.After treatment with methotrexate,the tumor size,and the range of inflammation and infection was reduced,the difference was statistically significant(P<0.05).The recurrence rate was 33.33%when patients were followed up 3 months later.Conclusion:Methylprednisolone combined with methotrexate can effectively relieve symptoms in patients with refractory granulomatous mastitis and is recommended to use it as early as possible within the first 4 weeks.