Management of idiopathic granulomatous mastitis with observation

•IGM is a benign breast disease that is becoming increasingly recognized and reported.•IGM is a self-limited condition that will resolve spontaneously without treatment in an average of 7 months.•Patience with the natural history can help avoid unnecessary operations or prolonged courses of medications.

BackgroundIdiopathic granulomatous mastitis (IGM) is becoming more commonly recognized and reported more often. Currently, many recommend corticosteroids in its management.MethodsA retrospective chart review was conducted from January 2002 to June 2013. Data were collected regarding sociodemographic information, clinical history, treatment, and outcomes.ResultsThirty-seven patients were found with IGM. Thirty-five patients were Hispanic born outside the United States. Early in the time period reviewed, 5 patients had masses excised and 5 patients were lost to follow-up. Twenty-seven cases of IGM resolved with observation. Corticosteroids were not used in the management. The average time to resolution was 7.4 months. Three patients (11%) had recurrent episodes after resolution.ConclusionsIGM is a self-limited benign condition that will resolve spontaneously without treatment. Patience with the natural history of IGM is important, as the process often includes periods of exacerbation before resolution.