Granulomatous Mastitis: Is it Boon or Bane??

Introduction: Granulomatous mastitis (GM) is a rare benign breast disease subdivided into idiopathic and specific. The clinical and imaging diagnosis is often challenging as it can mimic malignancy. It has characteristic histological features of multinucleated giant cells, non-caseating granulomas, and necrosis. The treatment is still controversial with steroid therapy as a primary modality and surgery are avoided due to fistula formation and recurrences. Aims and objectives: This study aims to establish the descriptive features of granulomatous mastitis and the correlation between various risk factors affecting and leading to the recurrence of the disease. Materials and methods: This was a retrospective study carried out for a period of 12 months at IBCC (Integrated Breast Care Centre) established in AIIMS, Rishikesh, Uttarakhand. Out of 2567 patients who presented to OPD, 34 patients were diagnosed with granulomatous mastitis included in this study. Results: Of all the 34 patients who presented with granulomatous mastitis, the mean age 38.32 yrs, all of them are females (100%) with a mean duration of 2.55 months. Breast lump noted in 82.4%, 85.3% with Pain, 17.6% had Discharge. On examination, the mean largest size is 3.41 ± 1.15 cm, 67.6% had Tenderness. We observed statistical significance (P<0.05) between pathological features, giant cells, AFB positivity, antibiotics, steroid, and antituberculosis treatment with recurrence. Conclusion: Granulomatous mastitis is a special disease scenario that will mimic malignancy but have low rates of transformation but it has more financial burden on patients due to its chronicity resulting in poor quality of life which is a Boon and Bane for these patients.