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

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.