Idiopathic Granulomatous Mastitis: Case Reports and Review of Literature

Abstract

Idiopathic granulomatous mastitis (IGM) is an uncommon benign disorder of the breast that can mimic two frequent breast disorders, breast carcinoma and breast abscess. In this report, we present two patients seen in a community teaching hospital over a period of one year, diagnosed with IGM after histological evaluation. One patient responded well to immunosuppressive therapy, but the second patient required bilateral mastectomy due to the severe and recurrent nature of the disease. IGM is a disorder that should be considered in the evaluation of women who present with painful breast disease. We discuss the diagnosis, clinical presentation and management of IGM.

Bilateral granulomatous mastitis after local nandrolone injection

“…A study of 1106 cases of benign conditions of the breast revealed the figure of 1.8% for GM [1], while in a study in Turkey, it constituted 6.8% of their surgical benign specimens [3]. The disease usually occurs in childbearing ages in the 3 rd and 4 th decades of life, but a range of 11 to 83 years has been reported in the literature [1,3,4]. Almost all affected women reported in different series have had a history of pregnancy and lactation, recent in many cases.…”

“…Almost all affected women reported in different series have had a history of pregnancy and lactation, recent in many cases. The etiology is unknown; association of the disease with pregnancy, breastfeeding and oral contraceptives (OCP) has been mentioned [1,[3][4][5][6]. Imoto et al focus on an association of the disease with hormonal changes.…”

“…The disease is seen more frequently in Hispanics and Asians, although occurrence in all races has been seen and ethnic disposition has not been established [1,3]. Many other factors have been postulated as causative, but never proven: local irritants, various infectious agents (viral, mycotic and parasitic), other hormonal disorders (increased serum prolactin), diabetes, smoking, alpha-1 antitrypsin deficiency [1,3,6].…”

“…Many other factors have been postulated as causative, but never proven: local irritants, various infectious agents (viral, mycotic and parasitic), other hormonal disorders (increased serum prolactin), diabetes, smoking, alpha-1 antitrypsin deficiency [1,3,6]. An immune-related pathophysiology due to oozing of secretions from milk ducts into lobules during pregnancy and lactation has been widely considered [1][2][3].…”

“…Granulomatous mastitis (GM) is a rare inflammatory benign breast disease which was first defined by Kessler and Wolloch in 1972 [1][2][3]. Etiology of the disease is still unrecognized, although its association with various disorders or body milieu changes have been described and discussed in the literature.…”