Strategies to treat idiopathic granulomatous mastitis: retrospective analysis of 40 patients.

BACKGROUND

Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease which often mimics breast carcinoma both clinically and radiologically. Confirmation of diagnosis is only made by histopathological analysis. This study aims to define clinical and demographic features of IGM patients and discuss the results of treatment modalities.

METHODS

Forty patients with IGM who were assigned in Istanbul Medeniyet University General Surgery Clinic between March 2008 and October 2013 were retrospectively analyzed.

RESULTS

Mean age was 39.07 ± 11.5. The most common complaint was breast mass (55%). Nipple retraction was present in 6 patients (15%) and 9 patients (22.5%) had fistulizing abscess. Two patients had erythema nodosum on the lower extremity. Breast ultrasonography (USG) (n:40), mammography (MG) (n:20), and magnetic resonance imaging (MRI) (n:20) were used for imaging. Selected treatment methods were antibiotics and anti-inflammatory agents (27.5%), steroids (15%), abscess drainage (40%), and surgical excision (17.5%). Fifteen patients had recurrence after their first line treatment protocol. Mean follow-up period was 24.85 ± 19.7 months.

CONCLUSION

Surgical excision still seems to be the best treatment method for IGM patients. Administration of steroids for large lesions prior to surgery may help minimize the lesion size and obtain better cosmesis.