Tuberculous Mastitis Presenting as Breast Abscess

Abstract

Tuberculous mastitis is a rare clinical entity and usually affects women from the Indian sub-continent and Africa. It often mimics breast carcinoma and pyogenic breast abscess clinically and radiologically, may both co-exist. Routine laboratory investigations are not helpful in its diagnosis. Fine needle aspiration cytology (FNAC) / biopsy are essential for diagnosis and tuberculosis culture when positive may be very useful to guide antimicrobial therapy. Antitubercular drugs in combination with aspiration or surgical drainage are usually associated with an excellent outcome.

Tubercular mastitis - a great masquerader

“…In extensive cases, a simple mastectomy has been advocated. Radical mastectomy is best avoided unless there is a co-existing malignancy (5). In the present case, the patient was given anti-tubercular therapy and the swelling decreased in size considerably within one month.…”

“…Demonstration of caseating granulomas with Langhans' giant cells from the breast tissue and involved lymph nodes may therefore be sufficient for the diagnosis (5). The Mantoux test is usually positive in adults in endemic areas for tuberculosis and is of no great help for the diagnosis of breast tuberculosis (3).…”

Our Eyes Can See Only What the Mind Knows: A Rare Case of Tuberculosis of Breast

“…Such a presentation is seen in less than 50% of all cases. [5] Other uncommon presentations include a typical undermined tuberculous ulcer, purulent discharge from the nipple or with a fluctuant swelling, which if inadvertently incised produces a discharging ulcer. [1,5,6] Active or healed lung lesions on radiographic examination are rare now-a-days.…”

“…[5] Other uncommon presentations include a typical undermined tuberculous ulcer, purulent discharge from the nipple or with a fluctuant swelling, which if inadvertently incised produces a discharging ulcer. [1,5,6] Active or healed lung lesions on radiographic examination are rare now-a-days. Although, it was initially believed that as much as 60% of breast tuberculosis was primary, [5] it is now accepted that mammary tuberculosis is almost invariably secondary to a lesion elsewhere in the body.…”

“…[1,5,6] Active or healed lung lesions on radiographic examination are rare now-a-days. Although, it was initially believed that as much as 60% of breast tuberculosis was primary, [5] it is now accepted that mammary tuberculosis is almost invariably secondary to a lesion elsewhere in the body. Primary infection of the breast, however, through abrasions in the skin or through the duct openings on the nipple is a possibility.…”