The Elliptical Aggregates – Idiopathic Granulomatous Mastitis - The Elliptical Aggregates – Idiopathic Granulomatous Mastitis - Open Access Pub

Idiopathic granulomatous mastitis was initially scripted in 1972 by Kessler and Wolloch and is cogitated as an infrequent, benign, chronic inflammatory disorder. It commonly implicates females of reproductive age group, especially women who have breast fed in the preceding five to six years. Idiopathic granulomatous mastitis is commonly discerned in Asia and Mediterranean region although true incidence is undetermined. Diverse ethnicities delineate a diverse disease prevalence. Elimination of adjunctive causes of granulomatous inflammation makes idiopathic granulomatous mastitis a diagnosis of exclusion. As per the natural history, idiopathic granulomatous mastitis is designated as a self limiting disorder 1. DOI10.14302/issn.2690-4837.ijip-19-3145 Disease Characteristics Essentially an uncommon condition of obscure origin, granulomatous mastitis simulates an abscess or carcinoma breast on radiography. As radiographic features are inconclusive, definitive diagnosis is usually obtained with a core tissue biopsy and histological analysis. Repetitive tissue sampling is required to exclude a metamorphosis into carcinoma breast. Associated aetiological factors such as various infections, duct ectasia or a distinctive autoimmune mechanism may not be discovered. Granulomatous mastitis frequently emerges in the third or fourth decade of life with a demonstrable age range betwixt 11 years to 83 years. Reoccurrence is observed in a significant percentage of instances and varies betwixt 5% to 50%. An infectious aetiology of granulomatous mastitis requires elimination as corticosteroids are contraindicated in infectious aetiologies 2, 3. Disease Pathogenesis Mechanism of inflammation in idiopathic granulomatous mastitis is comprised of an injurious deterioration of ductal epithelium followed by metamorphosis and luminal secretions within the lobular connective tissue. Localized inflammation within the connective tissue accompanied by migration of macrophages and lymphocytes within the inflamed region evokes a focal, granulomatous inflammatory response. However, pre-emptive factor triggering the inflammation remains elusive. Trigger factors indicated are constituted by pregnancy, lactation, autoimmune disorders, hyperprolactinaemia and tobacco consumption. Enhanced severity and duration of disease can be cogitated in inflammation arising within the puerperal period 2, 3. Of obscure aetiology, factors such as hormonal imbalance, autoimmunity, undetermined microbiological agents, smoking contraceptive pills, lactation, hyperprolactinaemia, infection with