{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:06:14Z","timestamp":1790186774203,"version":"4.1.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to clarify whether microabscess observed on pathological biopsy independently predicts recurrence in granulomatous lobular mastitis (GLM), and to compare recurrence risks across different treatment regimens stratified by microabscess status. Our findings may help clinicians design individualized anti-recurrence therapy for GLM patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort enrolled 520 women with pathologically confirmed GLM from a non-puerperal mastitis registry maintained at a provincial maternal and child health hospital. Patient records spanned January 2017 to December 2024, with all follow-up completed September 1, 2025. We collected demographic, laboratory, ultrasound, medication and surgical data for all participants. Cox proportional hazards regression models identified independent recurrence predictors. Kaplan\u2013Meier curves with log-rank tests were used to compare 1-year recurrence rates between patients with and without histologic microabscess. Subgroup analyses further tested whether quinolone use or surgical resection modified the prognostic impact of microabscess.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort\u2019s average age at GLM onset was 31.5 years; 268 patients (51.5%) had microabscess on histology, while 252 (48.5%) did not. Multivariate Cox regression identified affected breast laterality, histologic microabscess (HR\u2009=\u20090.605, 95% CI 0.413\u20130.886, P\u2009=\u20090.010), peripheral white blood cell count, anti-mycobacterial therapy, and corticosteroid use as independent recurrence predictors. Microabscess acted as a protective factor against relapse. The 1-year recurrence rate was lower in patients with microabscess (20.1%) than those without (28.6%, P\u2009=\u20090.021). Baseline comparisons revealed higher rates of quinolone administration and complete surgical excision among microabscess-positive individuals (P\u2009=\u20090.007 and P\u2009=\u20090.004, respectively). When restricted to patients receiving quinolones, the recurrence gap between microabscess-positive and negative cases widened significantly (19.7% vs 28.7%, P\u2009=\u20090.030); no meaningful intergroup difference emerged for patients who did not take quinolones (P\u2009=\u20090.432). Anti-mycobacterial medication reduced recurrence risk regardless of microabscess status, while corticosteroid use raised relapse risk. Abscess drainage only lowered 1-year recurrence for patients with microabscess (17.4% vs 27.0%, P\u2009=\u20090.036), with no measurable benefit for those without microabscess. Surgical resection, cephalosporins and bromocriptine showed no independent ability to reduce recurrence in either subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Histologically confirmed microabscess independently lowers recurrence risk in GLM. For patients with microabscess, a combined regimen of quinolones, abscess drainage and anti-mycobacterial therapy yields the best anti-relapse outcomes. Corticosteroid use markedly increases recurrence likelihood. Treatment decisions for GLM should be adjusted based on whether microabscess is present on pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358780","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:33:46Z","timestamp":1790184826000},"page":"e0358780","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Study on the influence of microabscess on the recurrence of granulomatous lobular mastitis and stratified treatment strategies"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9842-6275","authenticated-orcid":true,"given":"Jin","family":"Chen","sequence":"first","affiliation":[{"name":"Sichuan Provincial Women\u2019s and Children\u2019s Hospita, The Affiliated Women\u2019s and Children\u2019s Hospital of Chengdu Medical College","place":["Chengdu, China"],"department":["Breast and Thyroid Department, Sichuan Provincial Maternity and Child Health Care Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiefang","family":"Dai","sequence":"additional","affiliation":[{"name":"Sichuan Provincial Women\u2019s and Children\u2019s Hospital, The Affiliated Women\u2019s and Children\u2019s Hospital of Chengdu Medical College","place":["Chengdu, China"],"department":["Ultrasound Department, Sichuan Provincial Maternity and Child Health Care Hospital"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruiyang","family":"Wu","sequence":"additional","affiliation":[{"name":"Breast Center, West China Second University Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Breast Center, West China Second University Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"pone.0358780.ref001","first-page":"186","article-title":"Research progress on granulomatous lobular mastitis","volume":"31","author":"LY Lan","year":"2021","journal-title":"Med New Knowl"},{"key":"pone.0358780.ref002","first-page":"1489","article-title":"Pathogenesis, diagnosis and treatment progress of granulomatous lobular mastitis","volume":"30","author":"C Chen","year":"2024","journal-title":"Chin J Bas Gen Surg"},{"issue":"5","key":"pone.0358780.ref003","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/GCO.0000000000000541","article-title":"Corynebacterium kroppenstedtii: a challenging culprit in breast abscesses and granulomatous mastitis","volume":"31","author":"N Saraiya","year":"2019","journal-title":"Curr Opin Obstet Gynecol"},{"issue":"31","key":"pone.0358780.ref004","doi-asserted-by":"crossref","first-page":"17040","DOI":"10.1021\/acs.analchem.5c02762","article-title":"Metabolism-Driven Colorimetric \"Read-to-Answer\" Sensor Array for Bacterial Discrimination and Antimicrobial Susceptibility Testing","volume":"97","author":"X Lin","year":"2025","journal-title":"Anal Chem"},{"issue":"9","key":"pone.0358780.ref005","article-title":"The Brief Case: Ventilator-Associated Corynebacterium accolens Pneumonia in a Patient with Respiratory Failure Due to COVID-19","volume":"59","author":"BM Liu","year":"2021","journal-title":"J Clin Microbiol"},{"key":"pone.0358780.ref006","first-page":"112","article-title":"Risk factors for recurrence of granulomatous lobular mastitis: a systematic review and meta-analysis","volume":"289","author":"S Akbulut","year":"2023","journal-title":"J Surg Res"},{"key":"pone.0358780.ref007","first-page":"89","article-title":"Research progress on recurrence risk factors and traditional Chinese medicine intervention for granulomatous lobular mastitis","volume":"48","author":"CY Hua","year":"2024","journal-title":"J Shanghai Univ Tradit Chin Med"},{"key":"pone.0358780.ref008","first-page":"993","article-title":"Chinese expert consensus on pathological diagnosis of granulomatous lobular mastitis (2024 edition)","volume":"53","author":"MM Shao","year":"2024","journal-title":"Chin J Pathol"},{"key":"pone.0358780.ref009","doi-asserted-by":"crossref","first-page":"1326587","DOI":"10.3389\/fmed.2024.1326587","article-title":"Pathological manifestations of granulomatous lobular mastitis","volume":"11","author":"L Cui","year":"2024","journal-title":"Front Med (Lausanne)"},{"key":"pone.0358780.ref010","first-page":"755","article-title":"Expert consensus on diagnosis and treatment of non-puerperal mastitis","volume":"36","author":"F Zhou","year":"2016","journal-title":"Chin J Pract Surg"},{"key":"pone.0358780.ref011","first-page":"1257","article-title":"Hunan expert consensus on diagnosis and treatment of granulomatous lobular mastitis (2021 edition","volume":"30","author":"CJ Zhang","year":"2021","journal-title":"). Chin J Gen Surg"},{"issue":"1","key":"pone.0358780.ref012","first-page":"20","article-title":"Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition)","volume":"9","author":"Q-Q Yuan","year":"2022","journal-title":"Mil Med Res"},{"key":"pone.0358780.ref013","first-page":"872","article-title":"Construction and validation of nomogram model for postoperative recurrence of granulomatous lobular mastitis","volume":"25","author":"S Aini","year":"2025","journal-title":"Prog Mod Biomed"},{"key":"pone.0358780.ref014","first-page":"1467","article-title":"Machine learning-based recurrence risk prediction model for granulomatous lobular mastitis at mass stage after surgery","volume":"31","author":"YY Xu","year":"2025","journal-title":"Chin J Bas Gen Surg"},{"key":"pone.0358780.ref015","first-page":"910","article-title":"Advances in diagnosis and treatment of granulomatous lobular mastitis","volume":"28","author":"CY Wang","year":"2023","journal-title":"Chin J Clin Pharmacol Ther"},{"issue":"3","key":"pone.0358780.ref016","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s10549-018-4870-3","article-title":"Granulomatous mastitis: etiology, imaging, pathology, treatment, and clinical findings","volume":"171","author":"DS Barreto","year":"2018","journal-title":"Breast Cancer Res Treat"},{"issue":"1","key":"pone.0358780.ref017","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1038\/s41392-024-01984-0","article-title":"Corynebacterium parakroppenstedtii secretes a novel glycolipid to promote the development of granulomatous lobular mastitis","volume":"9","author":"R Liu","year":"2024","journal-title":"Signal Transduct Target Ther"},{"key":"pone.0358780.ref018","first-page":"89","article-title":"Single-arm prospective clinical study of rifampicin triple anti-mycobacterial regimen for non-puerperal mastitis","volume":"13","author":"ZG Yu","year":"2024","journal-title":"Int J Infect Dis (Chinese Ed)"},{"key":"pone.0358780.ref019","first-page":"42","article-title":"Retrospective study on efficacy, prognosis and safety of dexamethasone in treatment of different subtypes of non-puerperal mastitis","volume":"29","author":"N Wang","year":"2026","journal-title":"Prog Gen Surg Chin"},{"issue":"6","key":"pone.0358780.ref020","article-title":"Evaluation of the efficacy, prognosis and safety of dexamethasone in the treatment of different types of non-puerperal mastitis: A retrospective study","volume":"20","author":"N Wang","year":"2025","journal-title":"PLoS One"},{"key":"pone.0358780.ref021","first-page":"410","article-title":"Retrospective analysis of 84 patients with non-puerperal mastitis","volume":"39","author":"Y Liu","year":"2018","journal-title":"J PLA Med Sch"},{"key":"pone.0358780.ref022","first-page":"439","article-title":"Idiopathic Granulomatous Lobular Mastitis \u2013 Report of 43 Cases from Iran; Introducing a Preliminary Clinical Practice Guideline","volume":"9","author":"S Karimi","year":"2014","journal-title":"Breast Care"},{"key":"pone.0358780.ref023","first-page":"327","article-title":"Chinese Society of Breast Surgery. Clinical practice guidelines for diagnosis and treatment of patients with non-puerperal mastitis: CSBrS practice guideline 2021","volume":"21","year":"2021","journal-title":"BMC Surg"},{"issue":"9","key":"pone.0358780.ref024","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1089\/bfm.2021.0023","article-title":"Pregnancy Associated Granulomatous Mastitis: Clinical Characteristics, Management, and Outcome","volume":"16","author":"S-B Li","year":"2021","journal-title":"Breastfeed Med"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358780","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T17:33:52Z","timestamp":1790184832000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358780"}},"subtitle":[],"editor":[{"given":"Benjamin M.","family":"Liu","sequence":"first","affiliation":[{"name":"Children\u2019s National Hospital, George Washington University","place":["UNITED STATES OF AMERICA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358780","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]}}}