[Idiopathic granulomatous mastitis - a rare inflammatory condition]

Area of Science:

• Breast Health
• Inflammatory Conditions
• Rare Diseases

Background:

• Idiopathic granulomatous mastitis (IGM) is a rare, chronic inflammatory breast disease of unknown cause.
• It primarily affects women of childbearing age, presenting with abscesses and potential breast deformation.
• Differential diagnoses include breast cancer and tuberculosis, necessitating accurate identification.

Purpose of the Study:

• To develop a guideline for the investigation and management of suspected Idiopathic granulomatous mastitis (IGM).
• To provide physicians with evidence-based strategies for diagnosing and treating IGM.
• To establish a multidisciplinary approach for optimal patient care.

Main Methods:

• A literature search was conducted in NCBI Pubmed, including thirty relevant studies.
• Flowcharts were developed for IGM investigation and treatment protocols.
• Diagnostic methods include cultures, DNA sequencing, biopsies, and blood tests.

Main Results:

• Recommended investigation includes bacterial/fungal cultures, DNA sequencing, core needle biopsy, blood tests, and skin punch biopsy.
• Ultrasound-guided drainage is advised for abscesses; surgery should be avoided.
• Treatment involves topical corticosteroids initially, followed by oral corticosteroids and methotrexate if needed.

Conclusions:

• IGM management requires a specialized multidisciplinary team due to its complexity.
• The guideline provides a structured approach to diagnosis and treatment, emphasizing conservative measures.
• An upcoming IGM registry study is expected to further enhance understanding and management.