A single center experience with a rare clinical entity of idiopathic granulomatous mastitis: Case series and review of the literature

Idiopathic granulomatous mastitis (IGM), also called autoimmune mastitis or granulomatous lobular mastitis is a benign, rare disease of the breast lobules. It is characterized by chronic non-caseating granulomatous sterile inflammation of the breast lobules. It is a disease of middle-aged women. Herein we report six cases of IGM the General Surgery Department at Palestinian Medical Complex (PMC) with a good response to treatment and significant improvement. The patients were followed-up for an average of 4-month period. Pathophysiology is uncertain. It has a wide differential diagnosis and malignancy should be ruled out. Its diagnosis is highly challenging and is only made by biopsy. Treatment options include medical and surgical therapy. Patients are usually started with a low dose prednisolone, other options include immunosuppressive agents, antibiotics, NSAIDs, colchicine and minimally invasive surgery. IGM has a high recurrence rate up to 40 % and long term follow up is advised. IGM is a rare breast pathology that evolves in an unpredictable manner over time. Clinical and radiological aspects vary and pose a diagnostic challenge, particularly in breast cancer. The pathological examination is still the most important component of certain diagnoses. The clinically correlated treatment is still debatable. •Idiopathic Granulomatous Mastitis (IGM), a rare benign breast disease, features chronic inflammation in lobules. Predominantly affecting middle-aged women, its etiology remains uncertain.•IGM's uncertain pathophysiology necessitates ruling out malignancy. Diagnosis, challenging and biopsy-dependent, offers varied treatment options—prednisolone, immunosuppressants, antibiotics, NSAIDs, colchicine, or minimally invasive surgery.•Despite treatment success, IGM boasts a 40% recurrence rate, underscoring the need for long-term follow-up. The choice between medical and surgical therapies remains debatable, emphasizing the intricacies in managing this condition.