The Effect of Western Medicine Therapies on Granulomatous Mastitis: a Meta-analysis

Abstract

To evaluate the clinical effectiveness of various Western medical therapies on the outcomes of granulomatous mastitis (GM), we conducted a meta-analysis of studies assessing the rates of complete remission and recurrence. We searched English and Chinese databases (Cochrane Library, PubMed, EMBASE, OVID, CNKI, VIP, and WanFang) for studies reporting complete remission and recurrence rates as a result of various Western medical treatments for GM, from inception foundation to November 2017. We retrieved references for additional studies. Two reviewers independently screened the literature, extracted information according to inclusion and exclusion criteria, and assessed methodological quality according to the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using the R 3.4.2 software. Thirty eligible studies were included, including 1483 patients with GM. Surgery, oral corticosteroids, surgery combined with oral corticosteroids, and observation alone were used more frequently than were other Western medical therapies. The complete remission rate of surgery combined with oral steroids medicine (90%) was higher than that of surgery (85%) (χ2 = 0.65, p < 0.05), oral steroids (77%) (χ2 = 0.91, p < 0.05), and observation (71%) (χ2 = 1.53, p < 0.05). The recurrence rate after surgery combined oral steroids (9%) was lower than that of surgery alone (21%) (χ2= 1.12, p < 0.05) or oral steroids (21%) (χ2 = 1.06, p < 0.05); however, there was no significant difference between surgery combined with oral steroids and observation groups (χ2 = 0.21, p = 0.74 > 0.05). Surgery combined with oral corticosteroids was superior to other therapeutic approaches in Western medicine. However, clinicians should select the treatment modality according to patients’ individual features.