Background: Idiopathic Granulomatous mastitis (IGM) is known as a rare condition, but it can mimic significant breast lesions like cancer. Variable nonspecific characteristics are present in IGM imaging. Objectives: The current study aimed to find the imaging characteristics of IGM among women of Sulaimani City in the Kurdistan Region of Iraq. Patients and methods: A retro prospective observational study was performed on 80 patients with IGM admitted to the Breast Center of Shar Hospital, from January 2014 to May 2022. The inclusion criterion was patients diagnosed histopathologically with IGM. Exclusion criteria were secondary granulomatous processes and incomplete patient data. We also reviewed ultrasonography (US), mammography, and magnetic resonance imaging (MRI) findings.
Results: Mean ages of patients was 35.8 (SD 5.7) years, and most of them (81.3%) were between 31 and 45 years of age. Most of participants were married and multiparous. Both breasts were nearly equally affected. Most patients (75%) presented with pain, followed by mass (70%). The commonest US finding was multiple hypoechoic masses and collections with tubular extension. Focal asymmetric increased density was the most frequent mammographic finding. MRI findings were asymmetric signal intensity change 10.0%, non-mass-like enhancement10.0%, type 1 enhancement 12.5%, and BI-RADS 3 in 10.0% of the patients. The BI-RADS score of most women who had MRI was upgraded. Conclusions: Imaging characteristics of IGM are variable; the US and mammography are helpful as initial exams. MRI gives more details on the disease and can be used to assess the extent of the disease, especially in complicated cases, and monitor treatment.