Alipour et al 2025 establish a link between 'milk stasis' and idiopathic granulomatous mastitis
Alipour et al 2025 aligns with the NDC mechanobiological model of breast inflammation
Alipour et al found that
-
One-sided breastfeeding was four times more frequent in idiopathic granulomatous mastitis (IDM) cases, with 70% discordance between the side of brastfeeding and the side of IGM.
-
Post-weaning brast engorgement happened three times more commonly in IGM patients
-
Lactational mastitis is twice as common in IGM cases.
The authors propose that their study shows that an increased incidence of 'milk stasis' during breastfeeding increases the risk of IGM in the years after weaning. Their study corroborates the NDC mechanobiological model of breast inflammation and places IGM on the spectrum of lactation-related breast inflammation as another kind of active end-stage inflammation.
Alipour et al 2025 abstract
Idiopathic granulomatous mastitis (IGM) is rare globally and infrequent in some middle-east regions. Sex-hormonal factors have been mentioned as predisposing factors for IGM, recent large-sale studies indicate a 7.5-fold increased risk in women who have breastfed. This study investigates BF-related factors that contribute to IGM development. We conducted a multicenter case–control study and recorder BF-related events in 730 IGM patients and healthy 760 controls. The mean age of participants was 36.63±6.49 in the Case and 36.96±6.11 years in the Control Group (p=0.31). IGM occurred more frequently in the contralateral breast in one-sided BF (p< 0.001), with discordance between the affected side and BF side in 68.3% of cases (p=0.005). Multivariate analysis revealed significant associations between IGM and one-sided BF (OR=4.21), post-weaning breast engorgement (OR=3.06), lactational mastitis (OR=1.93), and oral medication use for infants (OR=2.59). The study achieved 100% statistical power for both primary and secondary objectives, with narrow confidence intervals indicating high precision. This study provides robust evidence supporting the milk stasis hypothesis, demonstrating that BF-related issues leading to milk stasis are strongly associated with IGM development. Preventive strategies to minimize milk stasis and encourage bilateral BF may help reduce IGM risk.
Recommended resources
References
Alipour S, Tabatabaian M, Aziminezhadan P. From hypothesis to robust evidence in a nationwide multicenter case-control study on 1490 women: milk stasis and idiopathic granulomatous mastitis. Scientific Reports. 2025;15:37576. https://doi.org/37510.31038/s41598-37025-10784-37577