Comment on Idiopathic Granulomatous Mastitis with Skin Rupture: A Retrospective Cohort Study of 200 Patients Who Underwent Surgical and Nonsurgical Treatment
Abstract
To the Editor, We read with great interest the recent article “Idiopathic Granulomatous Mastitis with Skin Rupture: A Retrospective Cohort Study of 200 Patients Who Underwent Surgical and Nonsurgical Treatment” published by Wang and colleagues [1]. The authors stated that surgery after steroid therapy is an effective and more satisfactory treatment than steroid therapy alone in management of idiopathic granulomatous mastitis (IGM). The authors state that they start intravenous 5mg dexamethasone (DEX) and 2mg levofloxacin (LEVO) for 5 days to the patients that admitted with signs and symptoms of GM. Afterwards, they have performed surgery (n1⁄4 156) or steroid therapy (n1⁄4 44) that included oral prednisolone. We believe DEX is a good alternative in the initial treatment of IGM which is characterized as acute inflammatory disease, because it is 30 times more potent than cortisone and reaches the peak concentration rapidly after intravenous administration with a long half-life. Nevertheless, there are no studies suggesting DEX in the treatment of IGM and for this reason, authors should state how they decided the dosing of DEX in the present study. We believe the LEVO dose is mistakenly written as 2mg because according to recommendation of FDA correct dose of LEVO should be intravenous 750mg/single dose/daily. Authors have not stated how they have allocated the patients to surgery or steroid therapy groups and in our view, this is a source of bias. The authors have discontinued…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 200 participants or records.
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