Journals / Uludağ Üniversitesi Tıp Fakültesi Dergisi / 2026 / Cilt: 52

Association Between the Neutrophil-to-Lymphocyte Ratio and Recurrence in Idiopathic Granulomatous Mastitis

İdiyopatik Granülomatöz Mastitte Nötrofil-Lenfosit Oranı ile Nüks Arasındaki İlişki

Nihal Lermi(University of Health Sciences, Istanbul Kartal Dr. Lütfi Kırdar Health Research Center, Rheumatology Department, Istanbul, Türkiye.)0000-0002-2774-5913
Zeynep Yağbasan(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0003-1373-6140
N. Gul Ada Tak(Bursa Büyükorhan Integrated State Hospital, Internal Medicine Department, Bursa, Türkiye.)0000-0002-0449-2482
Burcu Yağız(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0002-0624-1986
Belkis Nihan Coskun(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0003-0298-4157
Yavuz Pehlivan(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0002-7054-5351
Hüseyin Ediz Dalkılıç(Bursa Uludağ University Faculty of Medicine, Division of Rheumatology, Bursa, Türkiye.)0000-0001-8645-2670
Pages
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Publication Date
2026-09-03
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Lower NLR levels were associated with recurrence in patients with IGM; however, NLR alone did not demonstrate sufficient predictive performance and may be more useful when interpreted together with other clinical parameters.

📌 3 Key Takeaways

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Objective & Hypothesis:Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory breast disease with a relapsing course.
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Key Findings & Data:This retrospective single-center study included 130 patients diagnosed with IGM and followed at the Rheumatology Outpatient Clinic of Bursa Uludağ University Faculty of Medicine between January 2019 and April 2024.
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Conclusion & Impact:Lower NLR levels were associated with recurrence in patients with IGM; however, NLR alone did not demonstrate sufficient predictive performance and may be more useful when interpreted together with other clinical parameters.
🔬Design:Araştırma Makalesi
📍Scope:2019 Verileri
⚙️Variables:Nötrofil-lenfosit oranı. · Nüks. · İdiopatik granülomatöz mastit.

Abstract

Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory breast disease with a relapsing course. The neutrophil-to-lymphocyte ratio (NLR) has been investigated as a potential inflammatory biomarker in various diseases. This study aimed to evaluate the association between NLR and recurrence in patients with IGM. This retrospective single-center study included 130 patients diagnosed with IGM and followed at the Rheumatology Outpatient Clinic of Bursa Uludağ University Faculty of Medicine between January 2019 and April 2024. Demographic characteristics, lesion features, laboratory parameters, treatments, and recurrence data were recorded. Binary Logistic Regression and Receiver operating characteristic (ROC) analyses were performed. All patients were female. The median age at diagnosis was 33 (21–64) years and the median follow-up duration was 16 (2–120) months. Recurrence developed in 63 (48.5%) patients. Multivariable analysis showed that younger age at diagnosis (OR: 0.88, p=0.022), menopause (OR: 122.87, p=0.007), lower NLR levels (OR: 0.14, p=0.003), and longer follow-up duration (OR: 1.06, p<0.001) were significantly associated with recurrence. No significant differences were observed in white blood cell count, neutrophil, platelet, erythrocyte sedimentation rate, or C-reactive protein levels. ROC analysis showed no significant predictive performance of NLR (AUC: 0.498, p=0.959). Lower NLR levels were associated with recurrence in patients with IGM; however, NLR alone did not demonstrate sufficient predictive performance and may be more useful when interpreted together with other clinical parameters.

Özet

İdiyopatik granülomatöz mastit (IGM), nükslerle seyreden nadir, kronik inflamatuvar bir meme hastalığıdır. Nötrofil-lenfosit oranı (NLR), çeşitli hastalıklarda potansiyel bir inflamasyon biyobelirteci olarak araştırılmıştır. Bu çalışmada IGM hastalarında NLR ile nüks arasındaki ilişkinin değerlendirilmesi amaçlandı. Bu retrospektif tek merkezli çalışmaya, Ocak 2019–Nisan 2024 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi Romatoloji Bilim Dalı Polikliniği’nde takip edilen 130 IGM hastası dahil edildi. Demografik özellikler, lezyon özellikleri, laboratuvar parametreleri, tedaviler ve nüks verileri kaydedildi. Binary lojistik regresyon ve alıcı işletim karakteristiği (ROC) analizleri uygulandı. Hastaların tamamı kadındı. Median tanı yaşı 33 (21–64) yıl, median takip süresi 16 (2–120) ay idi. Altmış üç (%48,5) hastada nüks gelişti. Çok değişkenli analizde daha genç tanı yaşı (OR:0,88, p=0,022), menopoz varlığı (OR:122,87, p=0,007), düşük NLR düzeyi (OR:0,14, p=0,003) ve daha uzun takip süresi (OR:1,06, p<0,001) nüks ile anlamlı ilişkili bulundu. Beyaz kan hücresi sayısı, nötrofil, trombosit, eritrosit sedimentasyon hızı ve C-reaktif protein düzeyleri açısından gruplar arasında anlamlı fark saptanmadı. ROC analizinde NLR’nin anlamlı prediktif performans göstermediği bulundu (AUC:0,498, p=0,959). IGM hastalarında düşük NLR düzeyleri nüks ile ilişkili bulundu; ancak NLR tek başına yeterli prediktif performans göstermedi ve diğer klinik parametrelerle birlikte değerlendirildiğinde daha yararlı olabilir.

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Cite This Article

Lermi, N., Yağbasan, Z., Tak, N. G. A., Yağız, B., Coskun, B. N., Pehlivan, Y., Dalkılıç, H. E., *, N. L. (2026). Association Between the Neutrophil-to-Lymphocyte Ratio and Recurrence in Idiopathic Granulomatous Mastitis. Uludağ Üniversitesi Tıp Fakültesi Dergisi, Cilt: 52. https://doi.org/10.32708/uutfd.1950919

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References (25)

  1. Kehribar DY, Duran TI, Polat AK, Ozgen M. Effectiveness of Methotrexate in Idiopathic Granulomatous Mastitis Treatment. Am J Med Sci. 2020;360(5):560-565. doi:10.1016/j.amjms.2020.05.029
  2. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol. 1972;58(6):642-646. doi:10.1093/ajcp/58.6.642
  3. Hashemi Moghanjoughi P, Neshat S, Heidari A, et al. Idiopathic Granulomatous Mastitis: A Comprehensive Review of Etiology, Diagnosis, and Management. Eur J Breast Health. 2026;22(2):126-138. doi:10.4274/ejbh.galenos.2025.2025-10-7
  4. Uysal E, Soran A, Sezgin E; Granulomatous Mastitis Study Group. Factors related to recurrence of idiopathic granulomatous mastitis: what do we learn from a multicentre study?. ANZ J Surg. 2018;88(6):635-639. doi:10.1111/ans.14115
  5. Barreto DS, Sedgwick EL, Nagi CS, Benveniste AP. Granulomatous mastitis: etiology, imaging, pathology, treatment, and clinical findings. Breast Cancer Res Treat. 2018;171(3):527-534. doi:10.1007/s10549-018-4870-3
  6. Benson JR, Dumitru D. Idiopathic granulomatous mastitis: presentation, investigation and management. Future Oncol. 2016;12(11):1381-1394. doi:10.2217/fon-2015-0038
  7. Yuan QQ, Xiao SY, Farouk O, et al. Management of granulomatous lobular mastitis: an international multidisciplinary consensus (2021 edition). Mil Med Res. 2022;9(1):20. Published 2022 Apr 26. doi:10.1186/s40779-022-00380-5
  8. Zhou F, Liu L, Liu L, et al. Comparison of Conservative versus Surgical Treatment Protocols in Treating Idiopathic Granulomatous Mastitis: A Meta-Analysis. Breast Care (Basel). 2020;15(4):415-420. doi:10.1159/000503602
  9. Ermurat, S., Aydoğdu, M. S., Altuner, M. Ş., Zontul, S., Cüre, O., Albayrak, F., Zengin, O., Kudaş, Ö., İnanç, E., Yolbaş, S., Akyol, L., Ketenci Ertaş, Ş., Babaoğlu, H., Balcı, M. A., Savaş, Y., Karataş, A., Artaş, H., Kısacık, B., & Koca, S. S. (2024). Idiopathic granulomatous mastitis: Multicenter study. Rheumatology Quarterly, 2(1), 31–39. https://doi.org/10.4274/qrheumatol.galenos.2024.40085
  10. Lermi N, Ekin A, Ocak T, et al. What predicts the recurrence in ıdiopathic granulomatous mastitis?. Clin Rheumatol. 2023;42(9):2491-2500. doi:10.1007/s10067-023-06651-3
  11. Gabay C, Kushner I. Acute-phase proteins and other systemic responses to inflammation. N Engl J Med. 1999;340(6):448-454. doi:10.1056/NEJM199902113400607
  12. Chen R, Li C, Chao K, et al. Neutrophil-to-lymphocyte ratio for predicting postoperative recurrence in Crohn's disease patients with isolated anastomotic lesions. Ther Adv Gastroenterol. 2023;16:17562848231165129. Published 2023 Mar 31. doi:10.1177/17562848231165129
  13. Çelen S, Kahraman O, Arslan H, et al. Does neutrophil-lymphocyte ratio show recurrence in non-muscle invasive bladder cancer? New J Urol. 2019;14(1):24-29.
  14. Ma J, Kuzman J, Ray A, et al. Neutrophil-to-lymphocyte Ratio (NLR) as a predictor for recurrence in patients with stage III melanoma. Sci Rep. 2018;8(1):4044. Published 2018 Mar 6. doi:10.1038/s41598-018-22425-3
  15. Çetinkaya ÖA, Çelik SU, Terzioğlu SG, Eroğlu A. The predictive value of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in patients with recurrent idiopathic granulomatous mastitis. Eur J Breast Health. 2020;16(1):61-65. doi:10.5152/ejbh.2019.5187.
  16. Kargın S, Turan E, Esen HH, Çetin Kargın N. Role of pre-treatment neutrophil-lymphocyte ratio in the prediction of recurrences after granulomatous mastitis treatment. Turk Klinikleri J Med Sci. 2020;40(1):46-51. doi:10.5336/medsci.2019-66835.
  17. Li Q, Wan J, Feng Z, Shi J, Wei W. Predictive Significance of the Preoperative Neutrophil-lymphocyte Ratio for Recurrence in Idiopathic Granulomatous Mastitis Patients. Am Surg. 2023;89(12):5577-5583. doi:10.1177/00031348231161793
  18. Ong SS, Ho PJ, Liow JJK, et al. A meta-analysis of idiopathic granulomatous mastitis treatments for remission and recurrence prevention. Front Med (Lausanne). 2024;11:1346790. Published 2024 May 30. doi:10.3389/fmed.2024.1346790
  19. Altintoprak F, Kivilcim T, Ozkan OV. Aetiology of idiopathic granulomatous mastitis. World J Clin Cases. 2014;2(12):852-858. doi:10.12998/wjcc.v2.i12.852
  20. Skandarajah A, Marley L. Idiopathic granulomatous mastitis: a medical or surgical disease of the breast?. ANZ J Surg. 2015;85(12):979-982. doi:10.1111/ans.12929
  21. Fattahi AS, Amini G, Sajedi F, Mehrad-Majd H. Factors Affecting Recurrence of Idiopathic Granulomatous Mastitis: A Systematic Review. Breast J. 2023;2023:9947797. Published 2023 Sep 26. doi:10.1155/2023/9947797
  22. Basim P, Argun D, Argun F. Risk Factors for Idiopathic Granulomatous Mastitis Recurrence after Patient-Tailored Treatment: Do We Need an Escalating Treatment Algorithm?. Breast Care (Basel). 2022;17(2):172-179. doi:10.1159/000517399
  23. Lai, E. C., Chan, W. C., Ma, T. K., Tang, A. P., Poon, C. S., & Leong, H. T. (2005). The role of conservative treatment in idiopathic granulomatous mastitis. The breast journal, 11(6), 454-456.
  24. Tekgöz E, Çolak S, Çinar M, Yilmaz S. Comment on ‘Treatment of idiopathic granulomatous mastitis and factors related with disease recurrence’. Turk J Med Sci. 2020;50(8):2073-2074. Published 2020 Dec 17. doi:10.3906/sag-2006-80
  25. Akalın Ç, Altaş H, Akçay Çelik M. White Blood Count Can Be a Practical Guide for the Differential Diagnosis of Breast Abscess and Idiopathic Granulomatous Mastitis. Cureus. 2020;12(9):e10468. Published 2020 Sep 15. doi:10.7759/cureus.10468