IDIOPATHIC GRANULOMATOUS MASTITIS

SYMPTOMS

Symptoms of Idiopathic granulomatous mastitis include:

• Breast Lumps or Masses: Palpable lumps or nodules within the breast tissue, which may be firm, irregularly shaped, and associated with tenderness or pain.
• Breast Pain or Discomfort: Persistent or intermittent breast pain, often localized to the affected area and exacerbated by touch or pressure.
• Breast Swelling or Redness: Swelling, redness, or skin changes overlying the affected breast area, resembling signs of infection or inflammation.
• Nipple Discharge: Clear or purulent discharge from the nipple, which may be spontaneous or elicited upon compression of the breast.

DIAGNOSIS

Diagnosing idiopathic granulomatous mastitis requires a comprehensive assessment, including clinical examination, imaging studies, and histopathological analysis of breast tissue. Diagnostic steps may include:

• Clinical Examination: A thorough physical examination of the breasts to assess for palpable masses, skin changes, or nipple abnormalities.
• Imaging Studies: Mammography and breast ultrasound are commonly used to evaluate the extent of breast abnormalities and guide further diagnostic procedures.
• Biopsy: A tissue biopsy, typically obtained through ultrasound-guided core needle biopsy or surgical excision, is essential for confirming the diagnosis of IGM and ruling out other conditions such as breast cancer.

Histopathological examination of the breast tissue biopsy reveals characteristic features of granulomatous inflammation, including the presence of multinucleated giant cells, epithelioid histiocytes, and fibrosis.

TREATMENT

The management of idiopathic granulomatous mastitis often involves a multidisciplinary approach, including medical therapy, surgical intervention, and supportive care. Treatment strategies may include:

• Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may be prescribed to alleviate pain and reduce inflammation associated with IGM.
• Immunosuppressive Therapy: In cases of severe or refractory disease, immunosuppressive agents such as methotrexate or azathioprine may be considered to modulate the immune response and prevent disease progression.
• Surgical Intervention: Surgical excision of affected breast tissue may be necessary to remove granulomas, abscesses, or fibrotic lesions and alleviate symptoms.
• Pain Management: Symptomatic relief of pain and discomfort through analgesic medications or local measures such as warm compresses or supportive garments.
• Regular Follow-up: Ongoing monitoring and follow-up evaluations are essential to assess treatment response, monitor for disease recurrence, and address any complications or side effects of therapy.