Background: Granulomatous disease within the breast can result from a variety of causes. Patients and Methods: We present 3 cases of this condition with 3 different underlying diagnoses. Results: Each case was initially labelled as idiopathic granulomatous mastitis, although this was proven not to be correct on further investigation. Conclusion: Clearly, identifying the correct underlying diagnosis is essential in granulomatous breast lesions as the treatment varies widely depending on the underlying aetiology. Effective communication and feedback in the context of the multidisciplinary team are vital to the diagnostic process in such challenging cases.