A Case Series of Idiopathic Granulomatous Mastitis and a Proposed Treatment Protocol

Abstract

Objective: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory breast disease. It has a poor-ly understood etiology. It can mimic breast cancer in clinical and mammographic findings. Some patients might improperly undergo mastectomy due to high suspicion of breast cancer. The objective of the present report is to discuss possible approaches to diagnosing and treating IGM based on a series of such patients.

Methods: This study retrospectively reviewed 17 cases of IGM. We discuss etiologic factors, clinical fea-tures, imaging findings, a variety of treatment options and outcomes. In conjunction with reviewing the literature, a treatment protocol for patients with suspected IGM was proposed.

Results: All patients were female and the median age at the time of diagnosis was 36 years (range, 21 to 53 years). Most patients (16 out of 17) were of reproductive age. In 16 patients who had undergone successful pregnancy, the last breast-feeding period was mostly less than 5 years to the onset of symptoms. All patients pre-sented with breast mass and pain. Twelve patients underwent mammography, which were categorized as either BI-RADS 4 in 7 patients, or BI-RADS 2 in 5 patients. All patients underwent remission after various multimodal-ity treatment approaches, including the use of corticosteroids, antibiotics, and surgery.

Conclusion: IGM is a benign inflammatory breast disease, mainly affecting women of childbearing age. Corticosteroids and wide excision play important roles in management.