İdiopatik Granülomatöz Mastitin Ameliyatsız ve Steroidsiz Tedavisi: Tek Beden Herkese Olmaz

Abstract

Aim: Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking malignancy
 with no consensus on the optimal treatment. We aimed to present a single-center algorithm for
 IGM treatment without surgery and steroids.
 Material and Methods: This study was conducted at Bülent Ecevit University Hospital, Zonguldak,
 Turkey, between 2010 and 2020. A prospective database was reviewed to identify patients with biopsyproven
 IGM who were managed through observation and ultrasound-guided interventions over a 10-
 year period.
 Results: Seventy-eight female patients with a confirmed diagnosis of IGM via reevaluation were
 determined. Of these, 34.61% required ultrasound-guided abscess aspiration and 10.25% required
 incisional abscess drainage without surgical resection. Complete clinical resolution was achieved within
 6 months in 58.97% cases. The overall recurrence rate was 12.82%, and surgical drainage was required
 in one patient. Univariate logistic regression analysis revealed no statistically significant association
 between recurrence and the demographic or pathologic factors evaluated. Twenty-two (28.2%) patients
 with a histopathologic diagnosis of cystic İGM who received antibiotics (doxycycline) achieved complete
 resolution within 2 weeks and experienced no recurrence.
 Conclusion: IGM is a self-limiting disease that resolves spontaneously independent of medical
 intervention and without resection in up to 18 months. After diagnosis, surgery with or without steroids as
 the first line of therapy should be replaced with close observation and ultrasound-guided interventions
 according to patients’ preferences.