Idiopathic granulomatous mastitis

Idiopathic granulomatous mastitis (IGM) is a rare, poorly understood condition that presents as inflammatory nodules of the breast. It is often initially misdiagnosed as furunculosis or cellulitis. Despite the painful, scarring, and debilitating nature of the disease, patients often have a delay in accurate diagnosis and treatment. Even when IGM is considered as a diagnosis, it is one of exclusion, with the differential diagnosis including serious conditions such as breast cancer, sarcoidosis, and cutaneous tuberculosis. Therefore, appropriate workup is important. Given that IGM is a disease of the skin, it is important for dermatologists to be familiar with its presentation. We describe 3 cases of young women with this condition and demonstrate that identification of triggers or methotrexate treatment is highly successful in sparing patients the drastic surgical alternative of mastectomy.