Risk Factors and the Role of the Albumin-to-Globulin Ratio in Predicting Recurrence Among Patients with Idiopathic Granulomatous Mastitis

Ahmet Burak Ciftci, Ömer Faruk Bük, Kürşat Yemez, Süleyman Polat, İrem Melike Yazıcıoğlu, Ahmet Burak Ciftci, Ömer Faruk Bük, Kürşat Yemez, Süleyman Polat, İrem Melike Yazıcıoğlu

Abstract

Background: Idiopathic granulomatous mastitis (IGM) is a rare inflammatory disease of the breast with a high recurrence rate. The serum albumin to globulin ratio (AGR) is a relatively novel biomarker in inflammatory diseases, and one whose role in the recurrence of IGM remains unknown. This study primarily investigated the potential risk factors for IGM recurrence and whether AGR can be used as a predictive factor.

Methods: Patients diagnosed with IGM from pathology reports between 2016 and 2021 were enrolled in the study, and their medical records were analyzed retrospectively. The patients were divided into two groups - recurrence and non-recurrence. Clinical, demographic characteristics, and laboratory parameters were compared.

Results: Eighty-five patients were included in the study, recurrence being detected in 16 (18.8%) of these, with a median follow-up time of 39.99±18.93 months. No relationship was determined between childbearing, breastfeeding, disease severity, or therapeutic approaches and IGM recurrence. While AGR was significantly lower in the recurrence group (p < 0.001), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) results were comparable in the two groups (p = 0.472 and p = 0.421, respectively). Multivariate analysis identified low AGR (odds ratio (OR): 50.7, 95% CI 5.93-434.1 P < 0.001) and smoking (OR: 4.45, 95% CI 1.04-18.9 P = 0.044) as independent risk factors for IGM recurrence.

Conclusion: The study findings indicated that AGR at a cut-off value of ≤1.179 at diagnosis and smoking exhibited a remarkable performance in predicting the recurrence of IGM. Developing new risk stratification systems for IGM recurrences and using AGR in these classifications may increase the success of treatment.

Trial registration: This study was registered with ClinicalTrials.gov, NCT05409586.

Keywords: albumin-to-globulin ratio; idiopathic granulomatous mastitis; recurrence; risk factors.

Conflict of interest statement

The authors declare that they have no conflicts of interest in this work.

© 2022 Ciftci et al.

Figures

Figure 1
Figure 1
The study flow diagram for selection of patients.
Figure 2
Figure 2
Boxplot of the distribution of (A) ALB (Albumin), (B) Protein, (C) Globulin and (D) AGR (Albumin-to-globulin ratio) values among IGM (idiopathic granulomatous mastitis) recurrence groups. Asterisk (*): Extreme outliers are data points that are more extreme than Q1- 3 * IQR or Q3 + 3 * IQR. Circle (o): Mild outliers are data points that are more extreme than Q1- 1.5 * IQR or Q3 + 1.5 * IQR.
Figure 3
Figure 3
The receiver operating characteristic (ROC) curve and the area under the ROC (AUC) of (A) ALB (Albumin), (B) Protein, (C) Globulin and (D) AGR (Albumin-to-globulin ratio) values in IGM (idiopathic granulomatous mastitis) recurrence prediction.

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