Tuberculous mastitis: A review of 32 cases

Abstract

Background: Breast tuberculosis (TB) is a rare disease, still present in endemic areas. The significance of breast TB is due to its rare occurrence and its resemblance to malignant breast lesions. The objective of this study was to study various clinical presentations and imaging features of different forms of tuberculous mastitis. Methods: A retrospective study was conducted over a 10-year period. Thirty-two consecutive patients diagnosed with tuberculous mastitis were included. Results: There was only one male patient in this series. The patients ranged in age from 25 to 60 years (mean age was 33.69 years). A solitary breast mass was the most common clinical presentation, which was associated with inflammatory findings in the majority of cases. The most common mammographic finding was diffusely increased density and the most common pathological finding was solitary mass. The most common appearance on ultrasound was of multiple intercommunicating breast masses with axillary lymphadenopathy. Conclusions: Breast TB should be considered in the differential diagnosis in the presence of a painful breast mass, discharging sinuses, mastitis, or a breast abscess that does not respond to conventional medical treatment. A multidisciplinary approach is required to aid timely diagnosis and to provide appropriate management and treatment in order to avoid complications.

Primary breast tuberculosis: imaging findings of a rare disease

“…Axillary lymph node involvement can be seen in 50-75% of cases [15,20,25] and the initial finding may be a pyogenic abscess [12,13,15,19].…”

“…Increases in focal (skin bulge) and diffuse (due to edema) thickness, as well as ductal ectasia, can also be detected by ultrasound [5,12,15,23].…”

“…If an abscess fistulizes to the skin, the fistula tract (Fig. 9) may also be visible with ultrasound [5,9,11,12,15,23].…”

“…Breast tuberculosis accounts for less than 0.1% of all breast pathologies [2,9] and has been reported as 3-4.5% of breast pathologies requiring surgery in developing countries [9,10]. Multipara and lactating women between the ages of 20 and 40 are more frequently affected [4,5,[11][12][13], while trauma and immunosuppressive conditions are among the other risk factors [3]. Breast tuberculosis can be either primary or secondary, but primary breast tuberculosis is extremely rare.…”

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

“…(4,8) Lesions due to tuberculosis have no specific radiological findings. (7,8) BTB is a great mimicker with no pathognomic clinico-radiological features hence can be easily misdiagnosed as a benign lesions such as antibioma, fibroadenoma, breast abscess, fatty necrosis, duct ectasia, granulomatous infections like idiopathic granulomatous mastitis, actinomycosis, Wegners granulomatosis, or neoplastic lesions like carcinoma. (2,7) In our study 34.2% were diagnosed provisionally as BTB rest 73.68% were misdiagnosed as fibroadenoma (16%), breast abscess (26.3%) or malignancy (23.7%)(2,7)…”