Comparison of Conservative versus Surgical Treatment of Idiopathic Granulomatous Mastitis

ABSTRACT
Background and Objectives: Idiopathic granulomatous mastitis (IGM) is a persistent inflammatory disease of the breast. This study aimed to evaluate the efficacy of medical, surgical, and combined treatment approaches in patients with IGM.
Patients and Methods: A retrospective study was performed on 130 women with histopathologically confirmed IGM who were treated at the Breast Clinic in Sulaimaniyah City, Kurdistan Region, Iraq, between 2011 and 2025. Patients received medical therapy, surgical therapy, or a combination of both. Statistical analysis was performed using the Chi-square test, Fisher’s exact test, and the Mann–Whitney test. A P value < 0.05 was considered significant.
Results: The mean patient age was 37.17 years. Antibiotics combined with corticosteroids were administered to 58 patients, and achieved remission in 93.1% (p = 0.001). Forty patients underwent drainage with antibiotics, corticosteroids, and anti-prolactin therapy, resulting in remission in 90.0% (p = 0.003). Wide local excision with antibiotics achieved remission in 41.7% (p = 0.1). While wide local excision combined with antibiotics and corticosteroids resulted in remission in 75.0% (p = 0.004).
Conclusions: Medical therapy alone or combined with limited surgical intervention showed higher remission rates and may be considered the preferred first-line management for IGM