Breast Tuberculosis- Clinical Spectrum and Management

Abstract

Objective of the study was to report the clinical spectrum, investigative profile and management of breast tuberculosis patients attending a tertiary care hospital. Breast tuberculosis is an uncommon form of tuberculosis. Knowledge of its varied clinical presentation and diagnostic modalities help in diagnosing this easily treatable disease. Retrospective data of 63 consecutive patients with breast tuberculosis was analyzed and information regarding demographic details, clinical presentation, cytology, histopathology and management was noted. Breast tuberculosis is essentially a disease of females (98.41%). 49.20% patients were below 30 years of age and 68.25% were from rural areas. Incidence of tubercular mastitis increases with parity (71.42% with p > 2). Commonest presentation was with painless lump (73%). Nodulocaseous tubercular disease was found in 74.60% patients whereas, 6.3% were of disseminated variety. Primary focus was detected in lungs in 11.1% patients, while 46.03% presented with loco-regional lymph nodes. FNAC was found to be a sensitive tool of diagnosis in 74.60% patients; however 25.39% cases were diagnosed with biopsy. ATT remained mainstay of treatment with surgical intervention as and when required. Breast tuberculosis despite being uncommon is not rare. Although diagnosis is not difficult but one should know where to suspect. Once confirmed treatment outcome is often rewarding.

Antitubercular Therapy in Breast Tuberculosis and in Diagnostic Dilemma with Chronic Recurrent Mastitis: Bangladesh Perspective

“…Direct extension from the chest wall (pleura or ribs) or and by inoculation of broken skin or duct openings can occur. Haematogenous spread is comparatively rare, Jah H et al [17] Studies reported axillary lymph node enlargement in 50%-70% cases of mammary tuberculosis which explained the retrograde lymphatic extension from axillary lymph nodes to breast [18].…”

Características clínicas y anatomo-patológicas de las pacientes que ingresaron al Programa de Control de Tuberculosis con diagnóstico de tuberculosis de mama

“…Se caracteriza por la ausencia de manifestaciones clínicas específicas; pero, la presentación más frecuente suele ser un nódulo unilateral de menos de un año de evolución (12)(13)(14)(15)(16)(17)(18). En 10-60 % de los casos se asocia dolor y puede confundirse con una lesión carcinomatosa ya que en su forma avanzada se acompaña de retracción de la piel o pezón (12)(13)(14)(15)(16)19).…”

Breast Tuberculosis -A Need for a Diagnostic Algorithm

“…In patients presenting with a mass accompanied by sinuses diagnosis becomes quite easy. Sinus tracks are pathognomonic of tuberculosis [7]. These are invariably associated with an underlying mass.…”

“…This is a peculiar phenomenon typical of tuberculosis. Immunological tests in majority of cases are equivocal or inconclusive [7,8]. Hence they cannot be relied upon for diagnosis.…”