Clinical presentation and management of idiopathic granulomatous mastitis in a Middle Eastern country-a case series

Abstract

Introduction: Idiopathic Granulomatous Mastitis (IGM) is a rare and benign inflammatory condition of the breast. IGM cases have been poorly documented in the Middle East, highlighting the need for improved awareness. Aim and Methods: A retrospective review of medical records was conducted, at a specialist centre on the clinical presentation, radiological findings, histopathological features, treatment and outcomes of IGM patients. Results: We identified twenty-two patients with a mean age of 36.6 years (range: 25-51) at presentation to breast clinic. 21/22 (96%) patients presented with a breast lump. 17/22 (77%) patients had breast pain, 4/22 (18%) patients had nipple discharge and 7/22 (32%) had palpable lymph nodes. GM was diagnosed histopathologically in 50% of fine needle aspirates, and 94% of core biopsies of breast. Conservative treatment was the sole treatment in 27%, while surgical management was undertaken in 5% of the patients. Conclusion: IGM appears to be a prevalent concern amongst Middle Eastern countries. There appears to be a diminishing role of surgery in its management and the role of immunosuppressants is emerging.