Tubercular Mastitis Masquerading as Carcinoma Breast in Elderly Female: A Diagnostic Dilemma

Abstract

AbstractTubercular mastitis (TM), a great masquerader, is extremely rare in elderly. Diagnosis becomes challenging when patient’s age and clinical features favor carcinoma, as in our case, where a 70-year-old female presented with right breast lumps associated with overlying ulcers and right supraclavicular lymphadenopathy. Fine-needle aspiration cytology of breast lump and lymph node followed by special staining and culture confirmed TM and lymphadenitis. Antitubercular therapy was initiated, and the patient got prompt relief. Here, we have discussed clinicocytological aspects of TM mimicking as carcinoma breast and diagnostic approach that should be undertaken. The case highlights the value of precise diagnosis, as specific treatment is indicated for tubercular and other granulomatous mastitis; placing an emphasis on meticulous investigation to rule out possibility of lethal malignancy in elderly; and necessity to always keep possibility of even rare entity like TM, irrespective of age, especially in India, where tuberculosis is endemic.