Idiopathic granulomatous mastitis: dilemmas in diagnosis and treatment

Idiopathic granulomatous mastitis (IGM) is a benign rare inflammatory disease of the breast. Due
to its uncommon etiology, diagnosis and treatment is still unknown. Selection of a standard method for
diagnosing idiopathic granulomatous mastitis is sophisticated. In view of non-definitive clinical and imaging
finding, histopathology is the cornerstone of definitive diagnosis.
Objective: To determine and help solve the dilemma of treatment and diagnosis of idiopathic granulomatous
mastitis.
Methods: This historical cohort study was conducted on 48 patients who referred to the general surgery clinic of
Imam Khomeini Hospital of Urmia, were diagnosed with IGM and were histopathologically selected by census
using the registry system, in Urmia city, Iran, during 2010-2015 so that medical reports, ultrasonography (US)
and mammography (MMG) findings, follow-up information and recurrence rate were obtained from records. The
data were analyzed using SPSS software version 18 and descriptive statistics were used.
Results: According to records, 68.75% of patients (n=33) had palpable mass, 45.83% of patients (n=22) had
breast pain and swelling, erythema and 20.83% of patients (n=10) had purulent drainage. Of the 48 patients 12
(25%) had mammography, which revealed the following findings: mass with irregular border in 6 patients, skin
thickness in 2 cases (4.16%), and parenchymal asymmetry in 4 cases (8.33%). Minimum follow-up was 24 (range
24–56) months.
Conclusions: According to our findings, histopathology of the disease is fundamental for correct diagnosis.
Steroid therapy as a therapeutic method such as prednisolone was an effective and applicable choice in the
treatment of idiopathic granulomatous mastitis by decreasing in inflammation