IntroductionIdiopathic granulomatous mastitis (IGM) or granulomatous lobular mastitis is a rare chronic inflammatory disease of the breast in women (1). This disease commonly occurs shortly after a women’s last pregnancy with a history of childbirth and breastfeeding that increases, especially in developing countries (2, 3). Despite the reports of this disease, which show an increase in its prevalence in recent years, the cause of its etiopathogenesis remains little known and diversified (3). An autoimmune or hypersensitivity reaction is the most common hypothesis regarding the etiology of the disease. However, trauma to the epithelium of the mammary ducts and extravasation of milk or duct secretions to the connective tissue, hyperprolactinemia, oral contraceptives, or bacterial origin have been considered (3, 4).IGM usually presents with a unilateral or bilateral progressive painful breast lump. Patients with chronic IGM can develop fistulae, sterile abscesses, and nipple inversion (5). Bilateral IGMs have a higher relapse rate and more excellent resistance to medical therapies than unilateral IGMs (6). Histological evaluation applies to definite diagnosis while imaging methods differential diagnosis for breast cancer (3) because abscesses can lead to being mistaken for breast cancer (7). Therefore, after causes must be considered, including breast cancer, autoimmune breast disease, and infection, the final diagnosis of IGM is often made (4, 7).Although the most appropriate treatment protocol has not yet been identified, some studies recommend surgical removal, while others suggest medical treatment such as antibiotics, corticosteroids, immunosuppressants, and anti-inflammatory drugs (3). The results of our literature review about information and case report IGM are summarized and exhibited in Table 1.This study describes a patient who presented with a breast lesion diagnosed as IGM, and two months after treatment with prednisolone, she was infected by Brucella.
