Idiopathic granulomatous mastitis: Risk factors and management.

Area of Science:

• Reproductive Endocrinology
• Oncology
• Inflammatory Diseases

Background:

• Idiopathic granulomatous mastitis (IGM) presents diagnostic and therapeutic challenges.
• Potential predisposing factors include oral contraceptive pills (OCPs), pregnancy, breastfeeding, hyperprolactinemia, and autoimmune conditions.
• The etiology of IGM remains largely unknown.

Purpose of the Study:

• To identify significant risk factors associated with IGM.
• To evaluate the clinical experience and management strategies for IGM.
• To assess the efficacy of corticosteroid therapy (CST) and surgical interventions.

Main Methods:

• A case-control study involving 40 IGM patients and 40 controls.
• Initiation of CST for all IGM patients.
• Surgical intervention considered for non-responders to CST or those with complications.
• Follow-up for 6 months to monitor recurrence.

Main Results:

• Higher IGM incidence in young females, smokers, those with hyperprolactinemia, history of breastfeeding, and OCP users.
• Central breast involvement and multicentric disease were observed.
• CST led to mass disappearance in 12.5%, size reduction in 65%, and no change in 22.5%.
• Surgery was performed in 87.5% of cases, with a 5.7% recurrence rate.

Conclusions:

• IGM predominantly affects women of childbearing age.
• Key risk factors identified are parity, smoking, OCP use, and breastfeeding.
• CST should be the initial treatment to potentially avoid surgery; combined therapy may reduce recurrence.