Women’s Health and Breast Cancer

Statement of the Problem: Idiopathic Granulomatous Mastitis (GM) is a rare, benign, chronic breast condition which can cause repeated abscess or mass formation in bilateral breasts. This can severely affect the quality of life of women who are affected by it. The natural history of GM as well as its optimal management is not well understood. This study aims to study the demographics of patients with GM and evaluate the most effective treatment method. Methodology & Theoretical Orientation: A retrospective review of 18 patients diagnosed with GM between 2012 and 2018 in a single institution in Singapore was carried out. Patients’ notes and treatment records were reviewed. Findings: The median age of GM patients was 32.5 years old (24-58). 50% of them were Chinese, 27.8% were Malay and 11.1% were Burmese. 72.2% (13/18) of patients presented with a breast lump with 46.2% (6/13) of these patients presenting with a lump more than 5 cm. 22.2% (4/18) presented with a breast abscess. 94.4% (17/18) of patients were treated with steroids, 27.8% (5/18) underwent surgery and 22.2% (4/18) were given antibiotics in the course of their GM treatment. Patients experienced a median of two flares (1-8) on treatment. 47.1% (8 of 17 patients) achieved resolution on prednisolone and none in the antibiotics group. Only one patient in the surgery group achieved complete resolution, as she underwent bilateral mastectomy. One patient who was managed with watchful surveillance spontaneously underwent resolution. The odds of resolution were 3.56 times (p=0.30) more likely with prednisolone than surgery. None turned malignant. Conclusion & Significance: GM is a benign recurrent, relapsing breast inflammatory condition that affects young females. Prednisolone appears to be the most effective amongst all the current treatment options. A multi-center study to evaluate response to various treatment options would aid in understanding of the nature of the disease.