Idiopathic granulomatous mastitis (IGM) is a rare but deeply impactful inflammatory breast condition that primarily affects women of childbearing age, often following pregnancy or lactation. Although benign, the disease can take a serious toll on quality of life, causing persistent pain, skin changes, recurrent abscesses, and, in some cases, open draining fistulas that can be both physically and emotionally distressing.
At UAB, a dedicated Granulomatous Mastitis Clinic is offering hope to patients facing this complex and often frustrating diagnosis.
A difficult disease with limited consensus
IGM has long posed challenges for both patients and providers. Symptoms can linger for months or even years. Treatment approaches vary widely and range from systemic medications, like oral steroids or immunosuppressive drugs, to surgical intervention. Each option comes with trade-offs, including side effects, risk of recurrence, or complications related to wound healing.
“IGM is a devastating disease and very difficult to treat,” said Cathy Chen, M.D., clinical assistant professor in the breast imaging section within the UAB Department of Radiology. “It is extremely painful and can form open, draining cutaneous fistulas.”
Because there is no universal standard of care, providers must often tailor treatment strategies to each individual patient, something UAB is especially equipped to do.
A promising new option: intralesional steroid injections
One of the most exciting advances at the UAB Granulomatous Mastitis Clinic is the use of ultrasound-guided intralesional steroid injections. This targeted therapy allows clinicians to deliver medication directly into the affected breast tissue, reducing inflammation at its source.
“We’re really excited to be offering intralesional steroid injections for our patients,” Chen said. “So far, we have had incredible results.”
Unlike systemic therapies, which affect the entire body and can lead to unwanted side effects, this localized approach is designed to be both effective and well-tolerated. The procedure is quick, minimally invasive, and cost-efficient, an appealing combination for patients who may already be navigating a long and difficult clinical journey.
“We are able to inject steroid directly into the breast under ultrasound guidance,” Chen said. “This is a fast, low-cost treatment with essentially no side effects.”
Early outcomes have been particularly encouraging. Some patients have experienced rapid symptomatic relief, and in certain cases, the treatment has been described as life-changing.
Multidisciplinary care makes the difference
Beyond a single treatment modality, what truly sets the UAB Granulomatous Mastitis Clinic apart is its multidisciplinary approach. Treating IGM effectively often requires collaboration across specialties, including breast imaging, surgery, and medical management, to address both the physical and long-term aspects of the disease.
“UAB is uniquely positioned to provide the multidisciplinary care that is much more effective for treating this complex chronic disease,” Chen said.
Patients may receive intralesional steroid injections as a standalone therapy or in combination with systemic medications or surgical planning, depending on their needs. This flexibility allows providers to optimize outcomes while minimizing complications.
As awareness of IGM grows, so does the need for innovative and compassionate care models. The UAB Granulomatous Mastitis Clinic is not only advancing treatment options but also redefining the patient experience, offering faster relief, fewer side effects, and a clearer path toward remission.
“We’re highly motivated to expand this clinic and help other women achieve faster symptomatic relief and ultimately durable remission,” Chen said.