An Integrative Approach for Idiopathic Granulomatous Mastitis

INDIAN JOURNAL OF SURGERY(2020)

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Abstract
The World Health Organization established a strategy on traditional medicine activities to facilitate integration of traditional medicine into the national health care system. Traditional and complementary medicine is now addressed by a legislation in Turkey. The aim of this study is to explore an integrative approach from for idiopathic granulomatous mastitis. This is a retrospective study. Study was carried out on idiopathic granulomatous mastitis patients who were followed in the Breast Clinic at Istanbul Medipol University Hospital for between May 2015 and September 2018. Hirudotherapy and medical cupping therapy were applied as traditional and complementary medicine integratively in accordance with the related Regulation . Radiological imaging, microbiological and histological testing, side effects, and relapses were analyzed. Radiological response was evaluated at the end of the treatment. Follow-up consisted of clinical breast exam and imaging. Thirty patients with a mean age of 34.6 years were analyzed. The average duration of symptoms was 4.6 months. Common symptoms were breast mass (100%), tenderness to palpation (73.3%), erythema (56.6%), fistula formation and deformity (43.4%), and axillary lymph nodes (43.4%). After confirmation of diagnosis of idiopathic granulomatous mastitis, patients were treated with hirudotherapy combined with medical cupping therapy. Symptoms had completely resolved within 110.3 ± 24.70 days (range 90–180) after starting treatment, and complete radiological response was confirmed 3 months after the end of the therapy by breast ultrasound or magnetic resonance imaging (MRI). All patients were successfully treated, and no evidence of relapse was experienced within the follow-up period of 22.87 ± 12.47 months. Hirudotherapy and medical cupping therapy were observed as efficient methods. Further investigations are required to validate the results in larger numbers of patients with longer follow-up. ( ClinicalTrials.gov Identifier: NCT04096300).
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Key words
Hirudotherapy, Idiopathic granulomatous mastitis, Integrative medicine, Legislation, Medical cupping therapy, Traditional and complementary medicine
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