Conservative management of 154 patients with idiopathic granulomatous mastitis: Simple is better?

Abstract

PURPOSE: Both the aetiology and treatment of idiopathic granulomatous mastitis (IGM) is controversial and unnecessary resections can lead to over-treatment in such a benign disease. Our aim was to report our experience in patients with IGM managed mainly with conservative methods, such as antibiotics, drainages and corticosteroids.

MATERIAL AND METHODS: Pathology database from 2008 to 2018 was reviewed retrospectively. Demographics and symptoms were documented from patient charts. Follow-up information was obtained from clinical reviews, and severity and duration of symptoms were documented. All data were transferred to Excel file and the parameters were compared.

RESULTS: All 154 patients were women. Mean age was 35.9 years. Empiric broad-spectrum antibiotic, abscess drainage and steroid treatments were seen to be successful in most of the cases (95.4%). In patients with limited regression (2.5%) or persistant lesions (1.9%), a second cycle was employed with a total regression rate of 100%. Recurrence was seen one or two times in 23 (14.9%) and 2 (1.2%) patients in a mean follow-up period of 5.3 years. The average time of recurrence was 2.5 years (range, 9-74 months).

CONCLUSIONS: Conservative management could be efficacious for IGM, and less and simpler can be enough to achieve more effective results.