Bilateral Idiopathic Granulomatous Mastitis: A Case Report

Idiopathic granulomatous mastitis is a relatively rare chronic inflammatory breast disease often mistaken for more common breast disorders, breast abscess or infectious mastitis, and can mimic inflammatory breast cancer.1,2 Since it was first described in 1972 by Kessler and Wolloch3, there have been only 541 cases reported worldwide as shown in a 2011 review article.4 Most patients are women of reproductive age, most commonly aged 22 42.5 It frequently occurs two to six years after pregnancy.6 The lesion typically presents as a unilateral firm breast mass and can occur in any quadrants of the breast except in the subareolar area, sometimes with inflammation of overlying skin, abscesses and fistulae.7-10 It usually poses a complex diagnostic and therapeutic dilemma because of the unknown etiology. A tissue biopsy is necessary to confirm the definite diagnosis. It is characterized by noncaseous granulomas and microabscesses confined to breast lobules with the absence of any infection during histopathological evaluation.11,12