Five-year follow-up of idiopathic granulomatous mastitis

Background: Idiopathic granulomatous mastitis (IGM) is a benign and rare chronic inflammatory disease of the breast. Although there are various treatment modalities, an ideal treatment algorithm has not been defined.

Aims: We designed this study to evaluate the clinical status, duration of remission, remission rates, and treatment algorithm in patients with IGM during a 5-year follow-up period after immunosuppressive therapy.

Methods: This study was planned retrospectively in the rheumatology outpatient clinic including 63 patients with biopsy-proven IGM. Demographic characteristics, clinical findings, treatment options, and drug-free remission periods after treatment were obtained from the patient's records.

Results: The mean age of female patients with IGM was 36.4 ± 6.1 years. Remission was achieved in all patients receiving immunosuppressive treatment and the median remission period was 13.9 months. After 5 years of follow-up, the median remission time without medication was 46.1 months. There was a significant improvement in the laboratory parameters and clinical findings of the patients. The most preferred immunosuppressive agent in all patients was methotrexate, and the second was azathioprine.

Conclusion: During the 5-year follow-up period, no recurrence after immunosuppressive therapy was detected in IGM patients. As seen in the treatment management chart, methotrexate provided remission in the majority of patients.