Tubercular mastitis: An institutional experience from a tertiary care centre of northern India

Abstract

Background: Tuberculous mastitis (TM) is a rare extra pulmonary presentation of tuberculosis. It may be problematic to distinguish from carcinoma breast, a condition with which it may coexist. Fine needle aspiration cytology (FNAC) / biopsy are indispensable for diagnosis and tuberculosis culture when positive may be very valuable to guide antimicrobial therapy.Aims and Objectives: To disseminate the message to the concerned expertise that it can present a diagnostic problem on radiological and microbiological investigations, and thus a high index of suspicion is needed.Materials and Methods: 19 cases of tubercular mastitis between January 2012 to March 2014 were identified and included in the present study. Cytology and biopsy alongwith AFB stain was done for confirmation.Results: Age ranged between 23- 55 years (median 33 years). Axillary nodes were palpable in 9 (47.3%) patients. Acid Fast Bacilli stain which was positive in only 3 patients. All the 19 patients were started on antitubercular treatment.Conclusion: This study highlights the importance of early diagnosis and aggressive medical and if required surgical management to cure this disease.Asian Journal of Medical Sciences Vol.8(3) 2017 72-75

Breast Tuberculosis-a Rare Presentation of Common Disease With Diagnostic and Therapeutic Challenge.

“…Breast may become infected by tuberculosis infection by direct spread of ductal infection, haematogenous spread, lymphatic spread or spread from pleura or chest wall. (2,5,9). Secondary BTB is caused by retrograde lymphatic spread as suggested by Cooper, which is presumed by presence of ipsilateral axillary lymphadenitis in 33-50% cases of BTB as in our study it was 37% cases.…”

“…Mckeown and Wilkinson classified BTB based on pathogenesis as primary when the breast lesion was the only foci of tuberculosis and secondary when there was other foci elsewhere in the body apart from breast. (5,9) As per Vassilakos primary BTB is rare but many studies and in our study primary BTB was found in 89% of cases. This is debatable as breast tissue is resistant to tuberculous infection and EPTB foci in lymph node may be easily missed clinico-radiologically.…”

“…This is debatable as breast tissue is resistant to tuberculous infection and EPTB foci in lymph node may be easily missed clinico-radiologically. (2,3,9). Breast may become infected by tuberculosis infection by direct spread of ductal infection, haematogenous spread, lymphatic spread or spread from pleura or chest wall.…”

“…(12) The gold standard diagnostic test of BTB is detection of AFB by ZN staining by microscopy or by solid or liquid culture accounting for 12% positivity by ZN staining and 26% by culture is in various studies and but we found it to be 6% and 15.8% respectively due to paucibacillary samples. (6,9).…”