Plastic and reconstructive breast surgery techniques in the surgical treatment of idiopathic granulomatous mastitis: a single-center experience

PURPOSE: Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory breast disease with unknown cause and undefined treatment. Since it has a high recurrence rate, wide excisions are recommended for surgical treatment. This study aims to discuss the selection and outcomes of plastic and reconstructive breast surgery techniques following wide excision. METHODS: This study examines the prospectively recorded surgical outcomes of 18 patients who were diagnosed with IGM between 2020 and 2022. Following histopathological confirmation of all patients’ diagnoses, the most appropriate technique was used in conjunction with wide surgical excision. Preoperative standing drawings were made for all patients and operations were performed by the same surgical team under general anesthesia. All patients were monitored for 6 months for postoperative complications, recurrence, and aesthetic outcomes. RESULTS: The patients underwent surgery for recurrence (n = 8), recurrent abscess (n = 4), and persistent disease (n = 6), in that order. Patients were treated with dermoglandular flap transposition (n = 6), Wise pattern reduction mammoplasty (n = 3), vertical reduction skin incision (n = 3), inferior pedicle with Wise pattern reduction mammoplasty (n = 4), and free nipple reduction mammoplasty (n = 2) techniques following partial mastectomy. No major complications developed postoperatively. Two patients with recurrence benefited from topical steroid injections. CONCLUSION: A wide excision is required to prevent IGM recurrence during surgery. After wide excision, the simplest and most easily applicable plastic and reconstructive breast surgery techniques can yield successful results with acceptable complication and recurrence rates. In technique selection, we recommend an individualized surgical approach for effective patient management.