Breast Tuberculosis Research Articles

Primary breast tuberculosis mimicking breast cancer: an original study of imaging findings and differential diagnosis challenges.

Breast tuberculosis is a rare extrapulmonary manifestation of Mycobacterium tuberculosis, representing less than 0.1% of all breast pathologies in developed countries. However, in regions with high tuberculosis prevalence, such as India and Africa, its incidence is higher. The disease poses diagnostic challenges due to its ability to mimic breast carcinoma, leading to potential misdiagnosis and unnecessary surgical interventions. This study investigates the clinical and imaging characteristics of breast tuberculosis in a large cohort, with a specific focus on a rare case in a postmenopausal woman. A retrospective observational study was conducted on 1704 women who presented for mammography at the Alessandrescu-Rusescu National Institute for Mother and Child Health between 2019 and 2021. Clinical presentation, imaging results, and histopathological findings were analyzed to identify cases of breast tuberculosis. The study includes a comparative analysis with other granulomatous diseases and malignant breast conditions to highlight key diagnostic features. Among the 1704 patients, 714 (41.9%) presented with symptoms such as pain (35.4%), palpable lumps (13.2%), nipple discharge (4.3%), and breast appearance changes (2.1%). A rare case of primary breast tuberculosis was identified in a 69-year-old postmenopausal woman, presenting with a painless, palpable mass in the upper outer quadrant. Imaging demonstrated a hypoechoic mass with fine granular content and posterior acoustic enhancement, categorized as BIRADS 4A. The biopsy confirmed the diagnosis of breast tuberculosis. This study underscores the diagnostic complexity of breast tuberculosis, particularly in its ability to mimic malignancy. Through detailed imaging and clinical analysis, we emphasize the importance of biopsy in differentiating tuberculosis from breast cancer. Given the potential for misdiagnosis, clinicians should consider breast tuberculosis in differential diagnoses, especially in regions with high tuberculosis prevalence. Further research is needed to develop specific imaging criteria for earlier and more accurate diagnosis.

Breast Tuberculosis: A unique and rare association

Breast Tuberculosis: A unique and rare association

Unlocking the biological potential of transition metal complexes with Thiosemicarbazone ligands: Insights from computational studies

In the previous study, the synthesis and characterization of 4-(3-fluorophenyl)-3-thiosemicarbazide and benzaldehyde derivatives based thiosemicarbazone ligands and their Co(II), Ni(II), Cu(II), Zn(II) complexes were carried out to evaluate their malarial and oxidant and inflammatory inhibition abilities, demonstrating that these compounds have robust efficacy for these ailments. In the present research, to find out a combating agent against breast cancer, tuberculosis, bacterial and fungal ailments, the compounds were tested through MTT, microplate alamar blue and serial dilution protocols. ADMET and DFT investigation were analyzed against highly bioactive compounds (2, 7–10) to give a new insight about compound's reactivity, stability and drug likeness properties. Furthermore, activity results shows that the ligand (2) and its complexes demonstrate greater efficacy compared to ligand (1) and its complexes. The Cu(II) (9) and Zn(II) (10) complexes were observed as highly efficient for breast cancer (MCF-7 cell line), TB (H37Rv strain), bacterial and fungal ailments in comparison of standard drugs with 0.029 ± 0.001 μM IC50 value for (9) in anticancer activity and 0.0034 ± 0.0017 μmol/mL MIC value for (10) in anti-tuberculosis activity. In the molecular docking investigation, the various kind of binding interactions and lowest binding affinity of (9) (against 4RJ3 (−10.0 kcal/mol), 2VCJ (−7.9 kcal/mol)) and (10) (−7.8 and −8.3 kcal/mol for 5V3Y and 3PTY protein) support their bioactivity. This research highlights the pharmaceutical importance of transition metal complexes having thiosemicarbazones, presenting a significant approach for the discovery of potent anti-infectious agent.

Primary wound closure following surgical removal of tuberculous mass in breast tuberculosis

Primary wound closure following surgical removal of tuberculous mass in breast tuberculosis

Diagnostic Challenge: A case report of primary breast tuberculosis mimicking recurrent pyogenic breast abscess

Introduction: Breast tuberculosis is a rare form of extra pulmonary tuberculosis with its primary form considered even rarer. Case presentation: A 28-year-old female initially diagnosed with a breast abscess presented with chronic right breast pain and nipple discharge. Despite initial treatment, symptoms recurred, and further investigations revealed a space-occupying lesion. Fine needle aspiration confirmed recurrent breast abscess, but subsequent DNA detection of tubercular bacilli in the pus sample led to a diagnosis of primary breast tuberculosis, necessitating anti-tubercular therapy. Clinical discussion: Breast tuberculosis, being rare and often misdiagnosed as an abscess, poses diagnostic challenges. However, Persistent symptoms despite treatment should prompt consideration of breast tuberculosis in TB endemic regions. Conclusion: Primary Breast Tuberculosis might not have any systemic symptoms to drag the clinician towards a possible diagnosis so culturing the aspirate for acid-fast bacilli or looking for MTB DNA in the available clinical sample should always be kept in mind for better outcomes.

Pathological manifestations of granulomatous lobular mastitis.

Granulomatous lobular mastitis (GLM) is a rare inflammatory breast disease with unknown etiology, characterized by non-caseous granulomatous inflammation of the lobules, which infiltrate lymphocytes, neutrophils, plasma cells, monocytes, and eosinophils may accompany. GLM is often misdiagnosed as breast cancer due to the lack of specificity in clinical and imaging examinations, and therefore histopathology is the main basis for confirming the diagnosis. This review provides an overview of the pathological features of granulomatous lobular mastitis and cystic neutrophil granulomatous mastitis (CNGM, a pathologic subtype of GLM). As well as pathologic manifestations of other breast diseases that need to be differentiated from granulomatous lobular mastitis such as breast tuberculosis, lymphocytic mastopathy/diabetic mastopathy, IgG4-related sclerosing mastitis (IgG4-RSM), nodular disease, Wegener's granulomatosis, and plasma cell mastitis. Besides, discusses GLM and CNGM, GLM and breast cancer, emphasizing that their relationship deserves further in-depth exploration. The pathogenesis of GLM has not yet been clearly articulated and needs to be further explored, pathology enables direct observation of the microscopic manifestations of the disease and contributes to further investigation of the pathogenesis.

Breast Tuberculosis: Case report and review literature

Introduction: Extrapulmonary manifestations of tuberculosis are well documented, however breast tuberculosis is a rare site of involvement, as it represents 0.1% of breast diseases in developed countries and 3%-4% in endemic countries. Methodology: The present study refers to a case report of Breast Tuberculosis and a literature review carried out in the PUBMED database with the keywords “Breast Tuberculosis” and “Young Adult” in the last 10 years. Case Report: A 32-year-old female patient complained of painful nodules in her right breast, in addition to the growth of axillary lymph nodes, associated with constitutional symptoms. Afterwards, a histopathological puncture of the lesion was requested, which showed the presence of active tuberculosis, and a regimen was initiated. of standard antibiotic therapy. Discussion: Breast tissue is extremely resistant to the presence of Mycobacterium tuberculosis, however these characteristics can change physiologically. The clinical presentation is not very specific with the possibility of breast nodulation being painful or painless, with fistulation or retraction of the breast and formation of a local abscess. Therefore, the gold standard for diagnosis is Fine Needle Aspiration Cytology (FNAC), which can be associated with additional tests. The basis of treatment for breast tuberculosis is antibiotic therapy, with emphasis on ethambutol, pyrazinamide, rifampicin and isoniazid. Conclusion: Breast tuberculosis is one of the differential diagnoses of breast nodulations, with investigation by Fine Needle Aspiration Cytology (FNAC) in addition to other tests that assist in clinical reasoning that leads to appropriate therapy.

Case Series of Primary Breast Tuberculosis Presenting as a Lump: A Diagnostic Challenge

Tuberculosis of the breast is rare, even in countries where the disease is endemic. Breast tuberculosis usually occurs secondary to infection elsewhere. Less commonly, it may be the primary site with no demonstrable focus elsewhere. It is mainly encountered in immunosuppressed individuals, those with a history of trauma and suppurative mastitis. It commonly presents as a lump in the breast, but other presentations such as breast abscess, dull aching pain, nipple discharge, etc., have been reported. Multiparous and lactating women in their second to fourth decade are commonly affected. Studies have shown that microbiological diagnosis is limited to a few cases, and histopathology is the mainstay in diagnosing cases of breast tuberculosis. In the present case series, two cases (44-year-old and 40-year-old females) presented with a painless, ill-defined lump in the left breast. Another case (33- year-old female) presented with a lump in the left breast with dull aching pain. Constitutional symptoms were absent in all of the present case series patients. Microbiological positivity in the form of Cartridge-based Nucleic Acid Amplification Test (CBNAAT) positivity was seen in only one of the patients. Biopsy of all these cases showed non caseating granuloma. All the patients had primary breast tuberculosis with no other organ involvement. All the patients were started on standard antitubercular therapy with a fixed drug combination, following an initial delay due to the non caseating nature of the granuloma. All of them responded well to the therapy. The present case series compared the characteristics and delved deeply into the current data and research on breast tuberculosis to understand the same.

Breast Tuberculosis in Iran: A Comprehensive Review.

Tuberculosis (TB) remains a significant global health concern and kills millions of people every year. While TB can affect any organ in the body, breast TB is relatively uncommon. This study presents a comprehensive review of literature spanning 23 years, with a focus on cases of breast TB in Iran. Among the 96 cases found, the majority (89.6%) fell within the age range of 20-60, with a striking prevalence among women (98.9%). Common symptoms included pain and palpable mass, each presenting in approximately 60.4% of cases. Notably, only a quarter of patients had a confirmed history of exposure to a known TB case. Left breast involvement was more prevalent (58.3%), with ipsilateral lymph node enlargement observed in 40.6% of cases. Given the clinical presentation of breast TB, which often leads to misdiagnosis, a significant proportion of cases (68.7%) were diagnosed through excisional biopsy. Following a standard 6-month regimen of anti-TB drugs, relapse occurred in only 4.2% of cases. This study highlights the need for heightened awareness and vigilance in diagnosing breast TB, especially in regions with a high burden. Although breast TB poses diagnostic challenges, with prompt identification and treatment, the prognosis is generally favorable, with a low incidence of relapse.

A Retrospective Analysis of the Clinicopathological Features of Patients with Tuberculous Mastitis: A Single Institution’s Experience

Introduction: Tuberculosis remains a global health burden, especially in low- and middle-income countries. Breast tuberculosis is a rare disease with minimal research available. This disease produces a diagnostic challenge as the clinical presentation is variable, and diagnosis often requires additional investigations. This study was undertaken to determine the efficacy of cytology and histology, together with ancillary studies, in diagnosing tuberculous mastitis. Methods: This retrospective study was conducted in a Johannesburg Hospital over 5 years. Thirty-two patients with confirmed tuberculous mastitis were included. The patients were considered positive for tuberculous mastitis if histological or cytological findings were confirmed with either a positive tuberculosis culture, Ziehl-Neelsen stain, or polymerase chain reaction examination/GeneXpert. Results: This case series comprises 3 males and 29 females with a mean age of 35.66. A breast mass was the most common presentation. Over these 5 years, more biopsies were performed on inflammatory breast lesions than fine needle aspirations. There was a higher confirmation rate for cytology diagnoses compared to histology diagnoses. Conclusion: This study supports using fine needle aspiration combined with GeneXpert as the primary diagnostic modality in diagnosing tuberculous mastitis. This test combination is advantageous in resource- and financially constrained environments as it is relatively simple to perform, cost-effective, and has a rapid turnaround time.

A rare case of breast tuberculosis: case report

Abstract Breast tuberculosis is a rare form of extra-pulmonary tuberculosis. It accounts for less than 0.1% of breast conditions in developed countries but reaches about 3-4% in developing high TB endemic regions. It usually occurs in multiparous and lactating women. The clinical, radiological and pathological presentation may often mimic breast abscess, idiopathic granulomatous mastitis or carcinoma. The most common presentation is that of a lump. Constitutional symptoms are not usually present. The most common site is the right upper outer quadrant of the breast. It also occurs in association with Immunosuppression disorders such as HIV. Here we present a case of a young, multiparous non- lactating woman with tubercular mastitis, confirmed by FNAC of the mass. The Tuberculin skin test was positive and the patient improved with anti-tubercular treatment.

Breast Carcinoma and Tuberculosis in Axillary Lymph Nodes: A Case Report

The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma, this can mimic or complicate the staging of a malignant disease. Dual organ pathology can lead to interpretation difficulties and inappropriate treatment of tuberculosis as well as breast carcinoma. We report an observation of infiltrating carcinoma of the non-specific type of the breast in woman aged 39, where tuberculosis was found in the axillary lymph nodes in addition to metastases. The possible and simultaneous occurrence of breast carcinoma and tuberculosis should be mentioned in order to avoid difficulties of interpretation and allow adequate management of axillary tuberculous lymphadenitis and breast carcinoma.

Enhancing the reliability and accuracy of AI-enabled diagnosis via complementarity-driven deferral to clinicians.

Predictive artificial intelligence (AI) systems based on deep learning have been shown to achieve expert-level identification of diseases in multiple medical imaging settings, but can make errors in cases accurately diagnosed by clinicians and vice versa. We developed Complementarity-Driven Deferral to Clinical Workflow (CoDoC), a system that can learn to decide between the opinion of a predictive AI model and a clinical workflow. CoDoC enhances accuracy relative to clinician-only or AI-only baselines in clinical workflows that screen for breast cancer or tuberculosis (TB). For breast cancer screening, compared to double reading with arbitration in a screening program in the UK, CoDoC reduced false positives by 25% at the same false-negative rate, while achieving a 66% reduction in clinician workload. For TB triaging, compared to standalone AI and clinical workflows, CoDoC achieved a 5-15% reduction in false positives at the same false-negative rate for three of five commercially available predictive AI systems. To facilitate the deployment of CoDoC in novel futuristic clinical settings, we present results showing that CoDoC's performance gains are sustained across several axes of variation (imaging modality, clinical setting and predictive AI system) and discuss the limitations of our evaluation and where further validation would be needed. We provide an open-source implementation to encourage further research and application.

Primary tuberculosis of the breast from mankweng hospital

Object of study: To share our experience with a rare case of Primary Tuberculosis of Breast.
 The problem to be solved: Tuberculosis of the breast is a rare type of extrapulmonary tuberculosis and usually affects young lactating multiparous women. It accounts for less than 0.1 % of all breast pathologies. Tuberculosis of the breast is often misdiagnosed. Therefore, a high index of suspicion is needed when evaluating cases of breast abscesses, fistulae, or mass.
 Main scientific results: A case of a 27-year-old female with no known co-morbidities, HIV negative who presented to our Surgical Outpatient Department with a 1-year history of a painless left breast lump. No previous history of pulmonary tuberculosis was reported. Breasts ultrasonography indicated BIRADS (Breast Imaging-Reporting and Data System) V: lesion highly suspicious of malignancy. Histopathological analysis of the core biopsy showed features of a necrotizing granulomatous mastitis with adjacent fat necrosis. Ziehl-Neelsen stain was negative though histological results were worrisome of a mycobacterial infection. Patient responded well to antitubercular therapy as evidenced by lump regression, ulceration healed, peau d’orage currently resolved, and the overall size of the breast is going back to its normal state.
 The area of practical use of research results: Family medicine physicians, Primary health care center, District level or regional level hospital.
 An innovative technological product: a high index of suspicion tuberculosis is needed when evaluating cases of breast abscesses, fistulae, or mass. Awareness of this condition is important as it can clinically, and radiologically mimic breast carcinoma.
 Scope of application of an innovative technological product: Family medicine physicians, Primary health care center.

A Rare Case of Breast Tuberculosis Presenting in Non-Lactating Woman: A Case Report

A Rare Case of Breast Tuberculosis Presenting in Non-Lactating Woman: A Case Report

Breast Tuberculosis: A Case Report

The authors report a case of breast tuberculosis in a 58-year-old patient in which the diagnosis was made with difficulty, initially the case being interpreted as a neoplastic process. This diagnosis should be considered in such cases. In our area, in the present tuberculosis endemic, the cases of tuberculosis with extrapulmonary localisation are more and more frequent.

Imaging of tubercular mastitis presenting as recurrent breast nodules and abscesses: a rare case report

BackgroundTubercular mastitis could be a rare diagnostic find clinically. It is largely seen in Asian, African and alternative non-developed countries and might occur with coincident primary tuberculosis of the respiratory tract or spine. Primary breast tuberculosis (TB) is even rarer and presents with non-specific clinical signs of continual breast masses, inflammation and sinus tracts. It can be similar to bacterial inflammation/abscess and malignant pathologies on imaging. The key to identification could be a holistic combination of imaging, clinical, biochemical and histopathological analysis.Case presentationWe discuss a case of a 41-year-old lady who conferred at the start with tender breast nodules that progressed to continual, multiple abscesses and sinus tract formation. It had been an unusual and unanticipated presentation in breast followed by uncommon events throughout the course of the treatment forcing us to re-evaluate the primary diagnosis. A sequence of multiple diagnostic imaging and histopathological evaluations confirmed the identification of tubercular mastitis. Following prolonged treatment, there was vital reduction within the range and size of nodules and abscesses.ConclusionsSuch cases imitate bacterial abscess and cancer in their clinical presentation and imaging findings and are imperative to be diagnosed via a myriad of diagnostic tests with histopathology. Such a clinical presentation should warrant a differential of granulomatous inflammation of the breast in cases of non-responders to incision and drainage, prolonged antibiotic medical therapy and prolonged anti-tubercular treatment up to twenty four months after assessment of the individual response.

Mastitis tuberculosis: About an uncommon case report

Background: Mastitis tuberculosis is a very unusual form of extrapulmonary tuberculosis, even in endemic countries. The clinical and imaging features are not specific to this condition, which must be distinguished from other mammary pathologies, especially breast cancer, in order to avoid investigations and treatments that are sometimes mutilating. Case presentation: We report an uncommon case of breast tuberculosis in a 39-year-old woman. The ultrasound and mammography performed suggested a lesion suspicious of cancer classified as ACR 5. Pathological examination confirmed tuberculosis of the breast. Anti-tuberculosis medical therapy resulted in a complete cure of the condition. Conclusions: Mammary extrapulmonary tuberculosis is uncommon and presents a difficult diagnostic challenge that requires a high degree of suspicion, especially in endemic areas. The clinical and radiological pictures are misleading, and raise a diagnostic problem especially with breast cancer. But it is only the histopathological or bacteriological examination that allows a diagnosis of certainty.

A RARE CASE OF TUBERCULOSIS OF BREAST

Tuberculosis is caused by Mycobacterium tuberculosis and mainly affects the lungs. Breast tuberculosis (TB) is a rare localization of extra-pulmonary TB. Breast tuberculosis has a prevalence of 0.6% to 3.6% of all breast infective conditions in India. It appears mostly in women of reproductive, age, multiparous, lactating. It has been scarcely reported to infect male patients, mainly before puberty, as well as women of older age. Most commonly the disease presents as a lump in the central or upper-outer quadrant of the breast while multiple lumps appear less frequently. Often the presentation leads to misdiagnose breast tuberculosis with either breast carcinoma or abscess because lump can mimic breast carcinoma, being hard, with irregular border, xed to either the skin or the muscle or even to the chest wall. Treatment generally involves anti-TB medications with or without surgery

MOLECULAR DOCKING STUDY OF HENTRIACONTANE FOR ANTICANCER AND ANTITUBERCULAR ACTIVITY

Objective: The present study discusses the molecular docking study of Hentriacontane for its Anti-tubercular and Anti-cancer activity. Methods: Two protein targets were selected for the study and their structures were taken from RCSB Protein Data Bank in PDB format. Preparation of proteins was done using Discovery Studio 2021 Client. The structure of Hentriacontane was drawn using ChemDraw 20.0 and saved in Mol format. Molecular docking was performed using PyRx software. 3D and 2D docking interactions were visualized by Discovery Studio 2021 Client. Results: Hentriacontane has docked against the selected proteins, namely Extra-cellular regulated kinase–2 (ERK-2; PDB ID: 3QYW) and Shikimate kinase (PDB ID: 1ZYU). The compound has shown the best binding score against Shikimate kinase (-10.4 kcal/mol), and Extra-cellular regulated kinase–2 (-7.4 kcal/mol) than the standard drugs. Conclusion: Molecular Docking study indicates that Hentriacontane could be an effective inhibitor for the proteins under study. Hence, the compound may be considered a lead molecule and further investigation of its analogues may help in the development of novel drugs for the treatment of breast cancer and tuberculosis.