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Abstract：
Idiopathic granulomatous mastitis (IGM) is a benign, chronic inflammatory lesion of the breast. Immunoglobulin G4 (IgG4) associated disease is rare in the breast. In our study, we aimed to evaluate the efficacy of steroid treatment on IgG4 levels in tissue in patients diagnosed with IGM. Between 2008 and 2017, 55 patients diagnosed with IGM in our clinic were included in the study. Demographic, clinical, microbiologic and histopathologic characteristics, treatment modality and recovery time were evaluated retrospectively. Patients were divided into 3 groups according to tissue IgG4 levels: negative (Group I), infrequently and slightly positive (Group II), and highly positive (Group III). Group I patients had a complete response rate of 77.8%. In the rest of the patients (22.2%), insufficient response was detected from the beginning of the treatment. In Group II, the response rate was 91.3% and the permanent success rate after treatment was 87.0%. Although group III patients had a complete response at the beginning (95.65%), they relapsed in a short period of time (26.1%) after discontinuation of steroid treatment. At least one steroid-related side effect was observed in 47 (85.8%) patients in all groups. There is no consensus on the dose and duration of immunosuppressive treatment in IGM. In this study, responses to steroid treatment according to IgG4 concentration in pathologic breast tissue and recurrences after the end of treatment were determined. We think that high IgG4 concentration in the tissue is associated with recurrence and other immunosuppressive drugs should be added as maintenance after steroid treatment.
摘要：
特发性肉芽肿性乳腺炎（IGM）是一种良性，乳房慢性炎性病变。免疫球蛋白G4（IgG4）相关疾病在乳腺中很少见。在我们的研究中,我们旨在评估激素治疗对IGM患者组织IgG4水平的影响.在2008年至2017年期间，我们的诊所诊断为IGM的55例患者被纳入研究。人口统计,临床,微生物和组织病理学特征，对治疗方式和恢复时间进行回顾性评估。根据组织IgG4水平将患者分为3组：阴性（I组），不经常和略呈阳性(第二组)，和高度积极(第三组)。第一组患者的完全缓解率为77.8%。其余患者（22.2%），从治疗开始就发现反应不足.在第二组中，有效率为91.3%,治疗后永久成功率为87.0%.尽管III组患者在开始时完全缓解（95.65％），他们在停止类固醇治疗后的短时间内复发（26.1％）。在所有组的47名(85.8%)患者中观察到至少一种类固醇相关的副作用。关于IGM中免疫抑制治疗的剂量和持续时间尚无共识。在这项研究中,根据病理乳腺组织中IgG4的浓度确定对类固醇治疗的反应以及治疗结束后的复发.我们认为组织中的高IgG4浓度与复发有关，应在类固醇治疗后添加其他免疫抑制药物作为维持药物。
