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Objective: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory condition predominantly affecting women of reproductive age, particularly those with a history of breastfeeding. Although the precise etiology remains unknown, treatment strategies continue to be a subject of debate. This study aimed to compare the efficacy of intralesional steroid injections (ILS) with oral steroid therapy in managing IGM. Materials and Methods: A total of 72 patients, clinically and histopathologically diagnosed with IGM, were treated with either intralesional steroids (Group ILS, n=47) or oral steroids (Group OS, n=25) at a tertiary referral hospital between January 2022 and January 2024. The data were retrospectively analyzed. Results: The mean age of the patients was 33.5 years (range: 22-56). No statistically significant differences were observed between the two groups in terms of demographic characteristics, presenting symptoms, clinical findings, or laboratory results. The mean treatment duration was 6 months. There were no significant differences in treatment response or recurrence rates between the two groups. However, there was a statistically significant difference in the incidence of side effects, with 6.3% in the ILS group compared to 36% in the OS group (p=0.001). Conclusion: Given its ease of application, lower incidence of side effects, and comparable efficacy, intralesional steroid injections may be considered a first-line treatment option in the management of IGM. Keywords: Idiopathic granulomatous mastitis, premenopausal women, breastfeeding, local steroid, systemic steroid.

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