Idiopathic Granulomatous Mastitis, a Clinicopathological Review of 22 Cases

Abstract

Background: Idiopathic granulomatous mastitis is a rare chronic inflammatory disease and typically occurs in women at the reproductive life. The etiology, clinical course, and optimal treatment of this disorder remain obscure. The most common clinical presentation is a unilateral, firm, discrete breast mass, often associated with inflammation of the overlying skin. Because clinically the lesion can simulate carcinoma, definitive diagnosis is made using histopathology. The main purpose of this study was to present the clinicopathological features of patients with idiopathic granulomatous mastitis, as well as the authors’ experience with surgical treatment of these patients. Methodology: The unit’s pathology database and clinic letters for the time period from January 2005 to May 2010 were used to identify patients who had presented with idiopathic granulomatous mastitis. Results: 22 female patients with a mean age of 35.14 ± 6.07 were included. The patients ranged in age from 24 to 44 years. All patients were parous, the median number of their pregnancies was 2 (ranging from 2 to 6) and the median duration of the last delivery was 4 years (ranging from 1.4 to 14 years).19 patients had a history of breast feeding. 8 patients (36.4%) had used hormonal contraception. The right breast was involved in 8 (36.4%) cases and in 12 (54.5%) patients; the left breast was affected. Erythema was the most common presenting symptom. Surgery was the definitive procedure in all patients. 13 patients (61.9%) presented with recurrence. Conclusion: Increased recognition of this disease will improve its understanding and management of it. Longterm follow-up is necessary.