We have examined 5 patients with granulomatous mastitis retrospectively. The average age of the patients was 36.8 (range 24-47). 3 patients had clinical and 4 patients had radiological diagnosis of malignancy. Three of the patients had excisional biopsy, one had drainage of an abscess and incisional biopsy, and one had only incisional biopsy. Two patients had recurrence. The patient treated with drainage and incisional biopsy in the first operation had the diagnosis of recurrence in the same breast 3 months later. Her abscess drained for the second time. In 4 months the same patient had recurrence again and the patient’s lesion was excisied. No recurrence was seen in the 2-year follow up. The patient who underwent incisional biopsy in the first operation had recurrence in the same breast 7 months later and treated with total excision. 11 months after the second operation, the patient had recurrence in the other breast and an incisional biopsy was performed for the suspicion of malignancy. 3 months later she had recurrence again in this breast and treated with total excision. In the follow up period of 6 months she had no recurrences.
Patients with idiopatic granulomatous mastitis frequently have diagnosis of abcess or breast cancer preoperatively. Recurrence risk following limited surgical procedures like drainage or incisional biopsy seems to be high. Therefore total excision of the lesion is mandatory to decrease the rate of recurrence in the patients with granulomatous mastitis.