OBJECTIVE:To explore the clinical efficacy, cosmetic outcome, and safety of comprehensive pharmacotherapy (traditional Chinese medicine + hormone + antibiotic) combined with ultrasound-guided precise lesion resection plus primary microplasty in the treatment of refractory nonpuerperal mastitis (NPM). METHODS:The clinical and pathological data of refractory NPM patients who underwent surgical treatment at our hospital from February 2021 to December 2024 were retrospectively analyzed. The sample size was calculated using a superiority test, and a total of 97 patients were finally included. They were assigned to two groups using a random number table for retrospective stratification assignment (to balance baseline clinical characteristics and reduce selection bias): The control group (45 cases) underwent extended lesion resection combined with fascial flap plasty and nipple-areola correction and the observation group (52 cases) underwent ultrasound-guided precise lesion resection plus primary microplasty. The recurrence rate, breast cosmetic score (Harris score), postoperative psychological status (24-item Hamilton Depression Rating Scale [HAMD-24]), hospital stay, and incidence of complications were compared between the two groups. RESULTS:All surgeries were successfully completed in both groups without serious complications. All patients were followed up for more than 12 months (median follow-up period: 16.8 ± 2.9 months). There were no statistically significant differences in the incidence of postoperative complications [7.7% (4/52) vs. 6.7% (3/45), p = 1], drainage time [(3.5 ± 0.3) d vs. (3.6 ± 0.4) d, t = -1.398, p = 0.166], and hospital stay [(10.7 ± 0.6) d vs. (10.6 ± 0.5) d, t = 0.894, p = 0.373] between the two groups. The recurrence rate of the observation group was lower than that of the control group [0% (0/52) vs. 11.1% (5/45), X2 = 9.836, p = 0.002], and the cosmetic effect and patient satisfaction of the observation group were superior to those of the control group. The HAMD-24 score of the observation group [(7.8 ± 2.9) points] was lower than that of the control group [(12.5 ± 3.8) points], with a statistically significant difference (t = 11.562, p = 0.001). CONCLUSION:For refractory NPM, the combination of comprehensive pharmacotherapy, ultrasound-guided precise lesion resection, and primary microplasty achieves remarkable therapeutic effects, characterized by reduced complication rates and low short-to-long-term recurrence. This integrated traditional Chinese and Western medicine strategy is not only safe and effective but also provides excellent cosmetic benefits for patients.
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