Efficacy of surgical treatment in the management of idiopathic granulomatous mastitis: an institutional experience in Sri Lanka

Introduction
Idiopathic Granulomatous Mastitis (IGM) is a rare, benign, chronic inflammatory breast disease which can mimic a carcinoma both clinically and radiologically. This study aims to establish the efficacy of surgical treatment in the management of IGM.

Methods
We have retrospectively analysed 25 patients diagnosed with IGM between 2012-2019 who were managed surgically with wide local excision (WLE).  Ultrasound scans (USS) and fine-needle aspiration cytology (FNAC) were performed in all patients to confirm mastitis and to exclude malignancy. IGM was diagnosed by excisional biopsy. WLE was performed on all patients and were followed up to an average of 37 months. (range 3- 83 months, median 41.5 months)

Results
None of the patients showed recurrence of the disease during the period of follow-up. Post-operative complications observed included oozing from the surgical site (8%), wound site infection (4%), and minor skin necrosis (4%).

Conclusion
In the past, IGM has been managed in different ways ranging from observation, steroids, incision and drainage, with variable recurrence rates. As there is no accepted guideline up to date regarding the most effective treatment for IGM, we'd like to propose a surgical treatment with WLE as the treatment of choice due to the high rate of success and low rate of recurrence shown by our institutional experience.