ABSTRACT
Idiopathic granulomatous mastitis (IGM) is a rare benign disease of uncertain etiology having diagnostic
and therapeutic challenges which was treated surgically with poor outcome. This study tried to clarify the
diagnostic difficulties and to evaluate different lines of treatment and their outcomes. This is a prospective
describtive study included 9 patients with proven IGM based on clinical, radiological and pathological
examinations. The outcome of diffferent treatment options was evaluated after a mean follow-up period of
18.9±2.1 months. All patients presented with a history of a unilateral painful palpable breast lump.
Patients had a clinical presentation mimic inflammation in (56%) and malignancy in (44%).
Histopathology was conclusive in exclusion of other causes of granulomas thus diagnosing IGM while
ultrasonography and mammography was not. Eight patients out of nine responded to corticosteroid therapy
(mean 3.5 months) while one was resistant and responded to surgical excision. At follow-up (22%) had
recurrence and responded well to a second course of corticosteroid. A combination of surgery and medical
treatment for Idiopathic granulomatous mastitis according to the severity is better than any alone.