Abstract
Idiopathic granulomatous mastitis (IGM) is a rare, heterogeneous inflammatory breast disease lacking a universally accepted classification or a standardized management pathway. To provide a comprehensive narrative synthesis of the current literature on IGM and to contextualize the Turkish IGM clinical classification and treatment algorithm in relation to existing global evidence. A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar (2000-2025). Clinical, radiological, pathological, and therapeutic studies were examined. Previously published Turkish national consensus studies based on a modified Delphi process were incorporated into the synthesis. IGM remains diagnostically challenging due to its diverse presentations and overlap with malignancy. Existing global classification attempts are inconsistent and lack clinical practicality. The Turkish IGM clinical classification addresses these gaps by integrating lesion size, skin involvement, pregnancy/lactation categories, and extramammary findings. Treatment outcomes demonstrate the high efficacy of topical and intralesional steroids, the selective use of systemic immunosuppression, and the limited indications for surgery. The Turkish IGM classification and its associated treatment algorithm provide a practical, standardized framework that aligns with current evidence and may reduce overtreatment and mismanagement in IGM.