ABSTRACT

To evaluate the treatment responses and disease progression of the patients followed with the diagnosis of IGM by using the clinical, pathologic, laboratory and radiologic characteristics. Patients diagnosed as IGM in the rheumatology clinic between December 2017 and January 2020 were included in the study retrospectively. All patients were diagnosed with IGM as a result of clinical, laboratory, radiological and histopathological evaluations. The median age of the patients was 38 years. The number of patients with a history of lactation in the past 6 months was 2. Contraceptive use and active smoking were present in 2 patients. Painful, stiff and irregular mass and chronic ulcer wound were common findings in all patients. Breast ultrasonography (USG) was performed in all patients, mammography in 4 patients, and magnetic resonance imaging in 1 patient. While parenchymal heterogeneity, abscess and mass appearance were USG findings, asymmetric density was the main positive image of mammography. In breast biopsy pathology of all cases, in addition to chronic active inflammation, there were granuloma structures and necrosis areas surrounded by epithelioid histiocyte, lymphocyte, plasma cell, polymorphonuclear leukocyte and multinuclear langhanstype giant cells in several microscopic foci. Immunosuppressive therapy was given to all patients in combination with glucocorticoid. Complete remission was achieved in 40% of patients and partial remission in 20%. Surgical treatment was applied to 40% of the patients due to medical treatment resistance. Benign and malignant diseases of the breast can be confused with IGM. Unnecessary surgical and medical treatments can be prevented by making a differential diagnosis. The majority of patients respond well to immunosuppressive treatments. Surgical treatment is an important treatment option in patients who are resistant to medical treatment.