Summary about Disease
Idiopathic Granulomatous Mastitis (IGM) is a rare, chronic inflammatory breast disease. The term "idiopathic" means the cause is unknown. It's characterized by non-caseating granulomas (collections of immune cells) within the breast tissue. IGM is not cancerous but can mimic breast cancer symptoms, making diagnosis challenging. It typically affects women of reproductive age, often within several years after childbirth.
Symptoms
Painful breast lump(s).
Redness and swelling of the breast.
Skin ulceration or draining sinuses.
Nipple retraction.
Breast abscesses (collections of pus).
Swollen lymph nodes in the armpit (axilla) are sometimes present.
General feeling of being unwell (malaise) can also occur.
Causes
The exact cause of IGM is unknown (idiopathic). However, several factors are suspected to play a role:
Autoimmune response: The body's immune system may mistakenly attack breast tissue.
Hormonal factors: IGM often occurs in women of childbearing age, suggesting a possible link to hormonal changes, particularly related to pregnancy and lactation.
Infections: While not confirmed, some studies have explored a potential association with Corynebacterium species.
Alpha-1 antitrypsin deficiency: has been associated with IGM
Medicine Used
Treatment options vary depending on the severity of the disease and individual patient factors. Common medications used include:
Corticosteroids (e.g., Prednisone): These are often the first-line treatment to reduce inflammation.
Antibiotics: May be prescribed if there is a secondary bacterial infection.
Immunosuppressants (e.g., Methotrexate, Azathioprine): Used in more severe or refractory cases to suppress the immune system.
Anti-inflammatory medications: such as NSAIDS.
Is Communicable
No, Idiopathic Granulomatous Mastitis (IGM) is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
There are no specific precautions to prevent IGM since the cause is unknown. However, general health and hygiene practices are always important.
How long does an outbreak last?
The duration of an IGM outbreak can vary significantly. It can range from several months to several years. With treatment, symptoms can improve, but recurrence is possible. Some cases may resolve spontaneously, while others require prolonged treatment to manage the inflammation.
How is it diagnosed?
Diagnosis typically involves a combination of:
Clinical examination: Physical examination of the breast by a healthcare professional.
Imaging studies: Mammograms, ultrasounds, or MRIs can help visualize the affected area and rule out other conditions.
Biopsy: A tissue sample is taken from the affected area and examined under a microscope to confirm the presence of granulomas and rule out cancer. A core needle biopsy is typically performed first, but an excisional biopsy (removing a larger piece of tissue) may be necessary.
Ruling out other conditions: Tests may be done to exclude other causes of mastitis, such as infections or tuberculosis.
Timeline of Symptoms
The onset of symptoms can vary.
Initial Stage: Often presents with a small, firm, and painful lump in the breast.
Progression: The lump may enlarge, become more painful, and the skin overlying the lump may become red and inflamed. Abscesses or draining sinuses may develop.
Chronic Stage: If untreated, the condition can become chronic, with persistent inflammation, pain, and recurrent abscesses or draining sinuses. The timeline for each stage can vary from weeks to months.
Important Considerations
Differential Diagnosis: It's crucial to differentiate IGM from breast cancer, infectious mastitis, and other inflammatory breast conditions.
Treatment Monitoring: Regular follow-up with a healthcare professional is essential to monitor treatment response and adjust medications as needed.
Psychological Impact: The chronic nature of IGM and the uncertainty surrounding its cause can have a significant psychological impact on patients. Support groups or counseling may be helpful.
Fertility and Pregnancy: The effect of IGM and its treatment on fertility and pregnancy should be discussed with a healthcare professional.
Recurrence: Even with treatment, IGM can recur, requiring further management.