{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:58:38Z","timestamp":1792511918993,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Granulomatous lobular mastitis (GM) is an inflammatory breast disease with unknown etiology. Studies showed that some patients could achieve complete remission with corticosteroids and excisional surgery. However, some patients would suffer from corticosteroid resistance. We aim to report our single\u2010center experience with the highest number of corticosteroid\u2010resistant GM patients treated by methotrexate and low\u2010dose corticosteroid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical record database in our center was searched retrospectively for GM patients between January 2015 and January 2022. Patients suffered corticosteroid resistance and received methotrexate\u2010containing regimen were included in this study. The clinical characteristics, management and outcomes were collected and analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010one patients with the median follow\u2010up of 18\u2009months (range 5\u201361\u2009months) were included. The median age was 30\u2009years old (range 21\u201348\u2009years). The common initial complaints were breast mass, pain, and erythema. The initial treatment of 80 (98.8%) patients was methylprednisolone. Patients were switched to methotrexate and low\u2010dose corticosteroid due to corticosteroid resistance. Complete remission was achieved in 61 (75.3%) patients who received methotrexate and low\u2010dose corticosteroid with or without segmental dissection. Nineteen methotrexate\u2010resistant patients were referred for antimycobacterial treatment with the exception that one patient was lost during follow\u2010up. Thirteen of them achieved complete remission, and the other five gained partial remission and received segmental dissection. None of these methotrexate\u2010resistant patients recured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An approach with methotrexate and low\u2010dose corticosteroid should be considered as an alternative method to corticosteroid\u2010resistant GM patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15396","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T04:34:25Z","timestamp":1660624465000},"page":"2956-2963","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Methotrexate and low\u2010dose corticosteroid: An effective alternate against corticosteroid\u2010resistant granulomatous lobular mastitis"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5978-2292","authenticated-orcid":false,"given":"Chunxiang","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Breast Surgery, Chengdu Women's and 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of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine University of Electronic Science and Technology of China  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1317","article-title":"Idiopathic granulomatous mastitis in Hispanic women\u2014Indiana, 2006\u20132008","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_9_3_1","first-page":"135","article-title":"A retrospective study on 221 patients with granulomatous lobular mastitis treated by a combination of traditional Chinese medicine and western 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