Conservative management of 154 patients with idiopathic granulomatous mastitis: Simple is better?

Yuksekdag, Sema; Yildiz, Abdullah; Yildirak, Kadir; Ayranci, Gulcicek; Cibiroglu, Esin; Ezberci, Fikret; Unal, Ethem

PURPOSE Both the aetiology and treatment of idiopathic granulomatous mastitis (IGM) is controversial and unnecessary resections can lead to over-treatment in such a benign disease. Our aim was to report our experience in patients with IGM managed mainly with conservative methods, such as antibiotics, drainages and corticosteroids. MATERIAL AND METHODS Pathology database from 2008 to 2018 was reviewed retrospectively. Demographics and symptoms were documented from patient charts. Follow-up information was obtained from clinical reviews, and severity and duration of symptoms were documented. All data were transferred to Excel file and the parameters were compared. RESULTS All 154 patients were women. Mean age was 35.9 years. Empiric broad-spectrum antibiotic, abscess drainage and steroid treatments were seen to be successful in most of the cases (95.4%). In patients with limited regression (2.5%) or persistant lesions (1.9%), a second cycle was employed with a total regression rate of 100%. Recurrence was seen one or two times in 23 (14.9%) and 2 (1.2%) patients in a mean follow-up period of 5.3 years. The average time of recurrence was 2.5 years (range, 9-74 months). CONCLUSIONS Conservative management could be efficacious for IGM, and less and simpler can be enough to achieve more effective results. KEY WORDS Abscess drainage, Antibiotics Idiopathic granulomatous mastitis (IGM), Conservative management, Corticosteroids.