Predisposing Factors for Idiopathic Granulomatous Mastitis: A Large Prospective Multicentric Study

Sadaf  Alipour; Maryam  Tabatabaeian; Parisa  Aziminezhadan; Azin  Saberi; Maryam  Daneshpazhooh; Ramesh  Omranipour; Paniz  Famil-Amir; Najmeh  Ahmadi; Maryam  Sarkardeh; Nahid  Nafissi; Azadeh  Joulaee; Shahla  Astaraki; Zohreh  Zahernia-Shahrbabaki; Reihane  Tahery-Mehr; Maryam Gharini-Ahmadi; Behnaz  Khajeh-Ali-Beiki; Marzieh  Orouji; Bita  Eslami

doi:10.18502/ijph.v54i3.18258

Sadaf Alipour Breast Diseases Research Center (BDRC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Maryam Tabatabaeian Anahid Clinic, Isfahan, Iran
Parisa Aziminezhadan Aziminezhadan Breast Clinic, Tehran, Iran
Azin Saberi Department of Surgery, Arash Women’s Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Maryam Daneshpazhooh Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran
Ramesh Omranipour Breast Diseases Research Center (BDRC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Paniz Famil-Amir Aziminezhadan Breast Clinic, Tehran, Iran
Najmeh Ahmadi Anahid Clinic, Isfahan, Iran
Maryam Sarkardeh Department of Surgical Oncology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Nahid Nafissi Clinical Research Development Center (RCRDC), Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Azadeh Joulaee Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Shahla Astaraki Anahid Clinic, Isfahan, Iran
Zohreh Zahernia-Shahrbabaki Anahid Clinic, Isfahan, Iran
Reihane Tahery-Mehr Breast Diseases Research Center (BDRC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
Maryam Gharini-Ahmadi Department of Nursing, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
Behnaz Khajeh-Ali-Beiki Department of Nursing, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
Marzieh Orouji Department of Nursing, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
Bita Eslami Breast Diseases Research Center (BDRC), Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v54i3.18258

Keywords: Case-control study; Granulomatous mastitis; Breastfeeding; Risk factor

Abstract

Background: Idiopathic granulomatous mastitis (IGM) is a chronic breast disease with unknown pathophysiological and clinical aspects. Therefore, we designed this multi-center prospective case-control study to explore and clarify the risk factors with an acceptable sample size.

Methods: From March 2021 to December 2023, five hundred-four women with a histologically proven IGM were entered into the IGM group and 504 women with healthy breasts were included in the control group across nine centers. Participants' information was obtained by trained staff. Multivariate binary logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) for the associations between variables and IGM.

Results: The mean age of all participants was 34.92 ± 7.12 yr. The previous history of diseases as a whole, was significantly higher in the IGM group (33.1%) compared with the control group (26.6%). Logistic regression showed that previous lactation (OR= 7.51, 95% CI= 2.37-23.77) and a positive history of diabetes (OR = 4.23, 95% CI= 1.32-13.51) had a positive association with IGM, while OCP use (OR = 0.70, 95% CI= 0.52-0.93) was associated with IGM reversely.

Conclusion: The history of breastfeeding and not its duration is associated with a 7-fold increase in the rate of IGM. Furthermore, previous history of diabetes is a risk factor, while OCP use is a protective factor against IGM. We are designing another study to further investigate the relationship between breastfeeding, milk stasis, and IGM, based on our findings.