Abstract
BACKGROUND: Granulomatous mastitis is a chronic inflammatory breast condition characterized by non-caseating granulomas in the breast tissue, often requiring multidisciplinary approaches for accurate diagnosis and effective management. This study aimed to evaluate the efficacy and safety of ultrasound-guided microwave ablation (MWA) for the treatment of granulomatous mastitis compared with surgical excision. METHODS: This retrospective study analyzed the clinical outcomes of 65 consecutive patients with granulomatous mastitis treated with ultrasound-guided MWA (MWA group) and 60 patients treated surgically (surgery group) during the same period. Outcomes compared between the two groups included immediate effects, clinical cure rates, postoperative complication rates, recurrence rates, BREAST-Q satisfaction scores, and breast cosmetic score outcomes. Correlated variables were subsequently incorporated into a multivariate binary logistic regression model. RESULTS: (I) The MWA group was superior to the surgery group in terms of operation time, intraoperative blood loss (IBL), postoperative pain, and hospital stay (P<0.05). (II) There were no significant differences in cure rate (98.5% vs. 98.3%) recurrence rate (9.2% vs. 11.7%), and BREAST-Q satisfaction score (66.8±5.5 vs. 66.1±4.4) between the two groups (P>0.05). The incidence of postoperative complications in the MWA group was significantly lower than that in the surgery group (4.6% vs. 16.7%, P<0.05). (III) The breast cosmetic score in the MWA group was significantly higher than that in the surgery group (P<0.05). (IV) Multivariate logistic regression analysis revealed that therapy method (MWA or surgery) and breast cosmetic score were significantly associated with complication rate. CONCLUSIONS: Ultrasound-guided MWA is safe and effective in the treatment of granulomatous mastitis, which can be used as an alternative treatment method.