Clinicopathological features of idiopathic granulomatous mastitis: A retrospective study & educational lessons from Syria

OBJECTIVE: to determine the clinical presentations and histopathological findings of idiopathic granulomatous mastitis, and to evaluate clinical outcomes after management. METHODS: between 2007 and 2021, the files and histopathology reports of 17 patients with idiopathic granulomatous mastitis at Tishreen University Hospital, Latakia, Syria were reviewed. The data were analyzed and a scan through relevant literature was carried out to review related cases. RESULTS: the age of patients ranged from 23 years to 57 years, and the mean age was 37.2 ± 9.57 years. All patients were female. The most common clinical presentation was breast lumps and the most common mammographic finding was ill-defined masses, which mimics breast carcinoma. Multinucleated giant cells, polymorphonuclear leukocytes, lipogranuloma-like changes and lobulocentric abscesses were the most common histopathological findings. Treatment options include: drainage of abscess along with antibiotics, steroid administration, and surgical excision. Antibiotic treatment was associated with a higher rate of complications, while use of steroids showed complete remission of the disease. CONCLUSION: idiopathic granulomatous mastitis is a spectrum of entities that should be differentiated from breast carcinoma and other mastitis conditions, the infectious or the non-infectious ones. The clinical and radiological features resemble those of breast carcinoma and infectious mastitis. The histopathological study is considered as the most crucial element in the multidisciplinary approach to diagnose idiopathic granulomatous mastitis (IGM) and determine the optimal management to be administered.