Breast and endocrine surgery: idiopathic granulomatous mastitis: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Breast and endocrine surgery: idiopathic granulomatous mastitis

Sample item

A 32-year-old parous woman has a tender, firm breast mass with overlying erythema and no fever. Needle biopsy shows non-caseating granulomas centred on lobules with neutrophils. Acid-fast stain and cultures are negative. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Idiopathic granulomatous lobular mastitis

Idiopathic granulomatous lobular mastitis affects younger parous women and mimics cancer or abscess. Lobulocentric non-caseating granulomas with negative microbiology make the diagnosis after excluding tuberculosis, sarcoidosis and infections. Management ranges from observation to steroids.

Option by option

  • A. Tuberculous mastitis

    Tuberculous mastitis shows caseation or acid-fast bacilli.

  • B. Inflammatory breast carcinoma

    Inflammatory carcinoma shows dermal lymphatic tumour emboli and not granulomas.

  • C. Idiopathic granulomatous lobular mastitis (correct)

    Correct. Lobule-centred non-caseating granulomas with negative cultures fit this diagnosis.

  • D. Mammary duct ectasia

    Duct ectasia is a periductal inflammation of older women.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Idiopathic granulomatous lobular mastitis. Idiopathic granulomatous lobular mastitis affects younger parous women and mimics cancer or abscess.

Why is "Tuberculous mastitis" not the answer?

Tuberculous mastitis shows caseation or acid-fast bacilli.

Why is "Inflammatory breast carcinoma" not the answer?

Inflammatory carcinoma shows dermal lymphatic tumour emboli and not granulomas.

Why is "Mammary duct ectasia" not the answer?

Duct ectasia is a periductal inflammation of older women.

What concept does this question test?

It tests Breast and endocrine surgery: idiopathic granulomatous mastitis in General Surgery. Lobulocentric non-caseating granulomas with negative microbiology make the diagnosis after excluding tuberculosis, sarcoidosis and infections. Management ranges from observation to steroids.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Breast and endocrine surgery: idiopathic granulomatous mastitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.