Idiopathic granulomatous mastitis: A narrative review based on the Turkish consensus classification

Area of Science:

• Breast pathology
• Inflammatory diseases
• Clinical classification systems

Background:

• Idiopathic granulomatous mastitis (IGM) is a rare, heterogeneous inflammatory breast condition.
• Current diagnostic and management strategies lack standardization and universal acceptance.
• IGM presentations are diverse, often overlapping with breast cancer, posing diagnostic challenges.

Purpose of the Study:

• To synthesize current global literature on IGM.
• To contextualize the Turkish IGM clinical classification and treatment algorithm within existing evidence.
• To evaluate the practicality and efficacy of the Turkish approach.

Main Methods:

• A comprehensive narrative literature review was performed using major scientific databases (PubMed, Scopus, Web of Science, Google Scholar) from 2000-2025.
• Clinical, radiological, pathological, and therapeutic studies were examined.
• Incorporation of previously published Turkish national consensus studies based on a modified Delphi process.

Main Results:

• Existing global IGM classification systems are inconsistent and lack clinical practicality.
• The Turkish IGM classification integrates lesion size, skin and extramammary involvement, and pregnancy/lactation status.
• Topical/intralesional steroids show high efficacy; systemic immunosuppression is used selectively; surgery has limited indications.

Conclusions:

• The Turkish IGM classification and treatment algorithm provide a practical, standardized framework.
• This approach aligns with current evidence and may improve IGM management.
• The proposed system has the potential to reduce overtreatment and mismanagement of IGM.