A 10-year retrospective study of 43 female patients presenting with idiopathic granulomatous mastitis

Abstract

Background: Idiopathic Granulomatous Mastitis (IGM) is a rare inflammatory breast condition affecting middle aged women. IGM typically presents as a unilateral, painful and challenging-to-treat breast mass, with a high recurrence rate. Common treatments include corticosteroids and antibiotics, with surgical excision reserved for resistant cases. However, the absence of a standardized treatment protocol leads to variability in management across different settings and providers. Methods: We present a case series of 43 patients diagnosed with IGM at a community hospital in New York, aiming to facilitate early recognition and treatment of this rare condition. This study identifies risk factors and reviews best practices in imaging and treatment, emphasizing the importance of considering IGM in the differential diagnosis, particularly in cases of recurrent disease. Results: The sample comprised 43 patients with an average age of 34.65 years, 31 (72%) of whom were Hispanic. The most commonly reported symptoms were pain, mass, erythema, and swelling. In all cases, IGM was confirmed by histopathological examination. Treatment modalities included incision and drainage (I and D), corticosteroids, antibiotics, methotrexate and surgical intervention. Conclusions: IGM is a rare condition often mistaken for breast cellulitis, abscess or carcinoma. Maintaining a high index of suspicion is crucial, particularly in Hispanic women who may be at increased risk. Histopathological diagnosis is essential to prevent unnecessary surgical interventions and antibiotic use, thereby reducing recurrence rates. Early initiation of corticosteroids or alternatives like methotrexate can optimize patient outcomes and reduce healthcare costs.