Idiopathic granulomatous mastitis (IGM) is a rare, chronic, benign inflammatory breast disease of unknown etiology. Diagnosis requires exclusion of other specific causes such as infectious mastitis and breast tuberculosis. There is no established consensus on optimal treatment strategies for IGM. Traditional approaches primarily involve corticosteroids, administered either orally or topically. In recent years, disease-modifying antirheumatic drugs (DMARDs) have been increasingly introduced. Surgical intervention is typically reserved for refractory cases but is associated with a high recurrence rate. Some mild cases may resolve spontaneously through conservative observation. Furthermore, personalized combination therapy has become a key focus of research. This article reviews the pathological mechanisms, clinical manifestations, diagnosis, and treatment of IGM, with a focus on analyzing the therapeutic efficacy of corticosteroids, DMARDs, antibiotics, and surgery. The aim is to provide clinicians with effective management strategies and to promote the optimization of treatment protocols and the improvement of patient prognosis.
