Surgery speeds recovery in Idiopathic Granulomatous Mastitis

Background: Granulomatous mastitis is an uncommon breast condition. There are a variety of treatment modalities mentioned in the literature with limited consensus on optimal approach Methods: We performed a retrospective review of patients treated with idiopathic granulomatous mastitis at Austin and Northern health in Melbourne, Victoria, over the last 10 years. Multivariate analysis was used to elucidate contributing effects from different treatment modalities. Results: Patients were treated with surgical excision, steroids, abscess drainage, antibiotics, and observations. Surgical excision reduced the rate of recurrence significantly, compared to steroids (p < 0.01), simple drainage (p < 0.05) and antibiotics alone (p < 0.05). Patients undergoing surgery had significantly reduced time to clinical improvement and complete remission (75 days vs 254 days, p<0.05). In patients receiving surgery, addition of steroids did not improve recurrence rates (p = 0.28) Conclusion: Surgical excision should be considered in the treatment of all cases of granulomatous mastitis. Adjuvant therapies, including steroids and antibiotics, also have a role.