Figure 1:Clinical symptoms of case 1 This was a 33 years old patient who had recurrence at the upper outer part of the left breast 3 months after wide surgical excision. A, the fistula was presented on the left breast before anti-tuberculosis treatment. B, the fistula was cured after 6 months of anti-TB treatment.

Figure 2: Clinical symptoms of case 2 This was a 42 years old patient who accepted anti-TB treatment as primary therapy, who presented ulcerative skin lesions, sinus, abscess, and nipple retraction before treatment. A, ulcerative skin lesions were presented before anti-tuberculosis treatment. B, the ulcerative skin lesions were cured after 9 months of anti-tuberculosis treatment. C, the breast presented soft and normal 3 years later of follow up.

Figure 3 Multiple hypoechoic masses in the ultrasonographic evaluations of a patient with IGM. One lesion was located in the inner lower quadrant of the left breast (A), and another lesion was located in the outer upper quadrant (B).

Figure 4 Mammographic finding, showing a mass in the left breast of an IGM patient.

Figure 5 Microscopic findings for a core needle biopsy specimen, showing dilated ducts with a surrounding inflammatory infiltrate of lymphocytes, plasma cells, granuloma formation (?) and giant cells (?). (H&E stain �100 and inlet magnification �200).

Characteristics (n=36)	Positive	Negative

Breast lump	32 (88.9%)	4 (2.8%)

Painful swelling	22 (61.1%)	14 (38.9%)

Ulcerative skin lesions	10 (27.8%)	26 (72.2%)

Sinus formation	8 (22.2%)	28 (77.8%)

Nipple retraction	11 (30.6%)	25 (69.4%)

Abscess	6 (16.7%)	30 (83.3%)

Table1 Clinical characteristics of patients with IGM

Imaging modality	No. (%)

Ultrasonography (n=36)

Hypoechoic lobulated mass	16 (44.4%)

Mixed-echogenicity parenchymal mass	11 (31.6%)

Irregular tubular mass and parenchymal	9	(25%)
distortion

Abscess	6	(16.7%)

Skin thickening	8	(22.2%)

Fistula tract	5	(13.9%)

Axillary lymph node enlargement	10 (27.8%)

BI-RADS category 4-5	14 (38.9%)

Mammography (n=22)

Asymmetric increased density	10 (45.5%)

Ill-defined mass	3	(13.7%)

Calcification	1	(4.5%)

Axillary lymph node enlargement	7	(31.8%)

BI-RADS category 4-5	6	(27.2%)

Table2 Ultrasonography and mammography findings in patients with IGM

BI-RADS, Breast Imaging Reporting and Data System.

No.	Age	Location	Diagnostic	Pre-treatment	Drugs	Duration	Outcome

1	33	L	Biopsy	Drainage and wide	R+I+E	6 months	Cured
				excision

2	42	L	Core needle biopsy	-	R+I+E	9 months	Cured

3	36	R	Core needle biopsy	-	R+I+P	6 months	Cured

4	40	R	Core needle biopsy	Drainage	R+I+E	6 months	Cured

5	44	L	Core needle biopsy	-	R+I+E	6 months	Cured

6	39	R	Core needle biopsy	-	R+I+P	6 months	Cured

7	37	L	Core needle biopsy	Drainage	R+I+E	9 months	Cured

8	28	R	Core needle biopsy	-	R+I+E	1 months	Prednisolone

9	30	R	Core needle biopsy	-	R+I+E	6 months	Cured

10	46	R	Core needle biopsy	Prednisolone	R+I+E	9 months	Cured

11	36	R	Core needle biopsy	-	R+I+P	6 months	Cured

12	26	R	Biopsy	Drainage and wide	R+I+P	12 months	Cured
				excision

13	31	L	Core needle biopsy	-	R+I+E	6 months	Cured

14	26	R	Core needle biopsy	-	R+I+E	6 months	Cured

15	19	L	Core needle biopsy	Drainage	R+I+E	6 months	Cured

16	47	R	Core needle biopsy	-	R+I+E	6 months	Cured

17	39	L	Core needle biopsy	-	R+I+E	6 months	Cured

18	45	R	Core needle biopsy	Prednisolone	R+I+P	9 months	Mastectomy

19	34	R	Biopsy	Drainage and wide	R+I+E	9 months	Cured
				excision

20	29	R	Core needle biopsy	-	R+I+E	6 months	Cured

21	33	L	Biopsy	Drainage and wide	R+I+P	6 months	Cured
				excision

22	45	L	Core needle biopsy	-	R+I+E	6 months	Cured

23	30	L	Core needle biopsy	Drainage	R+I+P	6 months	Cured

24	40	R	Core needle biopsy	-	R+I+E	7 months	Cured

25	38	R	Core needle biopsy	Prednisolone	R+I+E	6 months	Cured

26	42	L	Core needle biopsy	-	R+I+E	6 months	Cured

27	37	L	Biopsy	Drainage and wide	R+I+P	10 months	Cured
				excision

28	48	L	Core needle biopsy	-	R+I+P	2 weeks	Prednisolone

29	56	R	Core needle biopsy	-	R+I+E	6 months	Cured

30	31	L	Biopsy	Drainage and wide	R+I+E	8 months	Cured
				excision

31	26	R	Core needle biopsy	-	R+I+E	6 months	Cured

32	39	R	Biopsy	Drainage and wide	R+I+P	8 months	Cured
				excision

33	44	L	Core needle biopsy	-	R+I+E	6 months	Cured

34	37	R	Core needle biopsy	-	R+I+P	6 months	Cured

35	42	L	Core needle biopsy	-	R+I+E	6 months	Cured

36	25	L	Core needle biopsy	Prednisolone	R+I+E	6 months	Cured

Table3 Clinical outcomes of 36 patients treated with anti-TB therapy

R+I+E, patients were treated with rifampicin plus isoniazid and ethambutol

R+I+P, patients were treated with rifampicin plus isoniazid and pyrazinamide