Breast Tuberculosis: A Disease not to be Forgotten

Introduction: Breast tuberculosis is a rare manifestation of extra-pulmonary tuberculosis which accounts for less than 0.1% of breast conditions in developed countries but reaches 3–4% in regions where the disease is endemic like India and Africa. It appears mostly in women of reproductive age who are multipara or lactating. The most common presentation is that of a tumor in the breast with or without ulcer or pus discharging sinus. Differential diagnosis includes breast cancer and chronic abscess. Materials and Methods: We report a case series of breast tuberculosis that were treated in a tertiary center. After a diagnosis of breast tuberculosis based on FNAC and histological finding, all the patients received anti-tubercular treatment and followed monthly to see the response. Result: On the triple assessment of breast lump, diagnosis of breast tuberculosis was confirmed by FNAC in two patient and Tru-cut biopsy and histological examination in four patients. One patient with biopsy report of necrotizing mastitis was labeled as breast tuberculosis on the basis of clinical suspicion. All patients showed a good response to ATT on monthly follow up. Conclusion: Although breast tuberculosis is a rare disease and can be misdiagnosed as breast cancer, a high index of clinical suspicion should be kept in mind during evaluation of breast lump, non-healing breast ulcer, and chronic sinuses. Early diagnosis based on clinical features and supplanted by FNAC and Tru-cut biopsy is suggested. Anti-tubercular therapy is effective.