EC Clinical and Medical Case Reports

Background: Idiopathic granulomatous mastitis is a rare inflammatory condition of the breast. Despite scientific advances, there remains uncertainty around aetiology and optimal treatment algorithms.

Methods: A retrospective observation study of 21 female patients treated at two major metropolitan health networks in Australia.

Results: The most common presenting symptoms were palpable lump (100%), pain (81%) and erythema (33%). Average time to diagnosis was 144 days, with average time to treatment 57 days. Five patients underwent operative excision, with complete remission in 80% of cases. Abscess drainage was used in 8 patients, requiring an average of 2.1 procedures for complete resolution after an average of 89 days. Antibiotic monotherapy was successful in three cases but failed in six cases. Average time to clinical improvement was 94 days, and time to complete remission was 157 days. Risk factors for prolonged treatment included larger lesions, smoking, and non-Caucasian ethnicity.

Conclusion: Idiopathic granulomatous mastitis mimics of other breast diseases, leading to delayed diagnosis and disparate initial management. Further research can help earlier identification of these patients to establish earlier treatment.

Keywords: Granulomatous Mastitis; Mastitis; Breast Diseases; General Surgery; Observational Study

1. Stevenson DR., et al. “Corynebacterium kroppenstedtii Breast Abscesses in Context, a Retrospective Cohort Study”. Journal of Medical Microbiology12 (2022).
2. Williams MS., et al. “Treatment of Granulomatous Mastitis: Is There a Role for Antibiotics?" European Journal Of Breast Health3 (2021): 239-246.
3. Yin Y., et al. “Idiopathic Granulomatous Mastitis: Etiology, Clinical Manifestation, Diagnosis and Treatment”. Journal of Investigative Surgery3 (2022): 709-720.
4. Yuksekdag S., et al. “Conservative Management of 154 Patients with Idiopathic Granulomatous Mastitis: Simple Is Better?" Annali Italiani di Chirurgia 91 (2020): 154-160.
5. Ma X., et al. “Different Treatments for Granulomatous Lobular Mastitis: A Systematic Review and Meta-Analysis”. Breast Care1 (2020): 60-66.
6. Martinez-Ramos D., et al. “Idiopathic Granulomatous Mastitis: A Systematic Review of 3060 Patients”. The Breast Journal6 (2019): 1245-1250.
7. Tasci HI., et al. “Factors Affecting Recurrence of Idiopathic Granulomatous Mastitis”. Journal of College of Physicians and Surgeons Pakistan2 (2022): 161-165.
8. Yuan QQ., et al. “Management of Granulomatous Lobular Mastitis: An International Multidisciplinary Consensus (2021 Edition)”. Military Medical Research1 (2022): 20.