Objective. Idiopathic granulomatous mastitis (IGM) is a disfiguring inflammatory breast disease without effective treatment. We report the largest IGM cohort treated with methotrexate (MTX) monotherapy. Methods. Chart review was performed on patients evaluated by the Stanford Immunology and Rheumatology Clinic, with histopathologically established IGM treated with MTX, and at least 1 followup appointment. Results. Nineteen female patients with a mean age of 33.5 years were identified. Most failed treatment with antibiotics, prednisone, and surgical intervention. By 15 months of treatment with MTX, 94% had disease improvement and 75% achieved disease remission. Conclusion. MTX monotherapy is an effective treatment for IGM.
Postolova, A., Troxell, M. L., Wapnir, I. L., & Genovese, M. C. (2020). Methotrexate in the treatment of idiopathic granulomatous mastitis. Journal of Rheumatology, 47(6), 924–927. https://doi.org/10.3899/jrheum.181205