Breast Tuberculosis Research Articles

Breast Tuberculosis: Radiology Spectrum with Clinical Correlation - A Retrospective Analysis of 13 Patients

Breast Tuberculosis: Radiology Spectrum with Clinical Correlation - A Retrospective Analysis of 13 Patients

Breast Tuberculosis: A Case Report

Breast tuberculosis (BT) or Tuberculosis mastitis (TM) is a very rare condition that’s not usually obvious to diagnose since it resembles many other conditions especially breast malignant tumor. It usually manifests as an irregular unilateral lump. Radiological findings are nonspecific. Ziehl Neelsen stain, culture and PCR for detection of Mycobacterium tuberculosis are considered as the mainstay for the diagnosis. However, biopsy with epithelioid examination seems to be more sensitive. We report a case of isolated breast localization of tuberculosis in a young female patient.

Isolated breast tuberculosis in an elderly diabetic woman

Isolated breast tuberculosis in an elderly diabetic woman

Ambiguity in Diagnosis of Extra-Pulmonary Breast Tuberculosis as Breast Abscess/Duct Ectasia

Ambiguity in Diagnosis of Extra-Pulmonary Breast Tuberculosis as Breast Abscess/Duct Ectasia

Feasibility of surgical management in patients with mammary tuberculosis-study of 100 cases.

Tuberculous mastitis is a rare entity in patients with mammary disease even in countries where incidence of tuberculosis is high. In Bangladesh, TB is an endemic disease but breast tuberculosis is rarely reported. Its clinical patterns and treatment strategies are changing day by day. With this study, we aimed to analyze the role of surgery in diagnosis and treatment of hundred (100) cases received care for tuberculous mastitis at the Chest Disease Hospital, Rajshahi, from July’ 2012 to July’ 2016. This is a prospective nonrandomized descriptive study. Diagnosis was made in all patients initially by cytological examination from suspected lesions, which revealed typical tuberculous lesions. In all the patients the diagnosis was confirmed by biopsy of the lesion (open biopsy or core cut biopsy) with histological examination and detection of acid fast bacilli in discharge by Gene x-pert test and Z-N staining to exclude idiopathic granulomatous mastitis, malignancy and very rare concomitant malignancy. Medical therapy with anti-tubercular drugs (ATT) ranging from 9 to 12 months with follow up monthly was the mainstay of treatment. Surgical intervention reserved for selected refractory cases (36%). Extension of anti-tubercular therapy from 9 to 12 or 18 months required in fifty-eight(58) patients on the basis of slow clinical response. Complete resolution obtained in 92 patients but residual tiny mass in eight patients confirmed by repeated FNAC or biopsy to be fibrotic. Surgery play an essential role both in diagnosis and treatment of tubercular mastitis in addition with ATT but beware about unnecessary surgical intervention as majority of patients cured with only ATT.TAJ 2014; 27(1): 44-49

Differentiation of breast tuberculosis and breast cancer using diffusion-weighted, T2-weighted and dynamic contrast-enhanced magnetic resonance imaging.

BackgroundThe use of multi-parametric magnetic resonance imaging (MRI) in the evaluation of breast tuberculosis (BTB).ObjectivesTo evaluate the value of diffusion-weighted imaging (DWI), T2-weighted (T2W) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating breast cancer (BCA) from BTB.MethodWe retrospectively studied images of 17 patients with BCA who had undergone pre-operative MRI and 6 patients with pathologically proven BTB who underwent DCE-MRI during January 2014 to January 2015.ResultsAll patients were female, with the age range of BTB patients being 23–43 years and the BCA patients being 31–74 years. Breast cancer patients had a statistically significant lower mean apparent diffusion coefficient (ADC) value (1072.10 ± 365.14), compared to the BTB group (1690.77 ± 624.05, p = 0.006). The mean T2-weighted signal intensity (T2SI) was lower for the BCA group (521.56 ± 233.73) than the BTB group (787.74 ± 196.04, p = 0.020). An ADC mean cut-off value of 1558.79 yielded 66% sensitivity and 94% specificity, whilst the T2SI cut-off value of 790.20 yielded 83% sensitivity and 83% specificity for differentiating between BTB and BCA. The homogeneous internal enhancement for focal mass was seen in BCA patients only.ConclusionMulti-parametric MRI incorporating the DWI, T2W and DCE-MRI may be a useful tool to differentiate BCA from BTB.

PRIMARY MASTITIS TUBERCULOSIS CLINICALLY MIMICKING FIBROADENOMA MAMMAE

Introduction: Breast tuberculosis (mastitis TB) is a rare extrapulmonary presentation of tuberculosis that marked pathologily with involvement extensively mamma lobules, which because of infection of Mycobacterium tuberculosis. Many epidemiology studies stated that the incidence of mastitis TB is more common in developing countries than developed countries. Mastitis TB occurs mainly in reproductive woman.
 
 Case: A 32-year-old woman came to Surgery Department with chief complaint right upper quadrant palpable breast lump for 4 months. Mammae dextra physical examination confirmed single nodule, size ± 3cm x 3cm x 2.5cm in superior quadrant, mobile, tender, well defined shape, feel like marble, reddish skin, warm, no skin retraction and no nipple discharge. VAS score 2. Mammosonogram was performed and indicated mastitis in the superior quadrant of mammae dextra. Fine needle aspiration revealed negative malignant cells and granulomatous with suppurative inflammation. The histopathological evaluation from mammae excision confirmed datia langhans cells and indicated granulomatous mastitis. Then patient referred to the Pulmonary Department. On TB pulmonary examination confirmed normal chest x-ray and negative acid fast basil (AFB). Patient was diagnosed with primary mastitis TB. Patient was treated with anti-tuberculosis drug (OAT) and gave good response and no side effects.
 
 Discussion: Based on the International Standards for Tuberculosis Care (ISTC) diagnosis of mastitis TB can be confirm by anamnesis, physical examination, and also some additional diagnostic test such as sonomammographic imaging, fine needle aspiration or surgical specimens for pathology examination and culture or AFB with Ziehl-Neelsen staining. In Indonesian National Guidelines for TB Control, mastitis TB was treated with fixed drug combination (FDC), intensive phase in 2 months using 4 FDC and advanced phase in 4 months using 2 FDC. In case followed up in 2 months, patient recovered very well and advised to continue the treatment.
 
 Conclusions: TB mastitis is rare even in countries with TB endemic. Diagnosis of primary mastitis TB based on clinical, radiological, pathological and microbiological. Treatment of mastitis TB with FDC for 6 months consists of an intensive phase and an advanced phase in this patient gave good outcome.
 
 Keywords: Mastitis tuberculosis, diagnosis, treatment.

Breast tuberculosis in Jakarta: Review of 7 cases

Introduction Breast tuberculosis (TB) is a rare manifestation of extrapulmonary TB. It can present with various clinical appearances, mimicking pyogenic abscess or breast cancer. Radiological, laboratory, and histopathology results are often inconclusive. Correct diagnosis of breast TB is required as the treatment consists of mainly antitubercular therapy, with only minimal surgical intervention.Cases We report seven cases of breast tuberculosis that was diagnosed with several diagnostic methods. All patients were treated with antitubercular therapy and showed good response.Conclusion Breast TB should be considered as differential diagnosis of breast lesion, especially in TB endemic countries, which one of them is Indonesia. Â

A rare case of fibroadenoma in ectopic breast tissue of axilla: case report

Developmental abnormalities of breast can lead to formation of ectopic breast tissue which may present as polymastia or polythelia or in form of swelling along the milk line. Ectopic breast tissue can also develop pathological changes similar to normal located breast tissue. This report is about a case of fibroadenoma developing in ectopic breast tissue of axilla. A thirty-four-year-old female presented with painful swelling in right axilla for 2 years and was diagnosed with fibroadenoma of axillary tail of right breast. Excision biopsy of the swelling confirmed the diagnosis of fibroadenoma. Fibroadenoma must be considered for any axillary swelling along with other differential diagnoses like lymphadenopathy, carcinoma arising from ectopic breast tissue, lipoma, sebaceous cyst, tuberculosis, vascular lesions, cutaneous malignancies or secondaries in lymph nodes. Ectopic breast tissue should be subjected to similar evaluation and screening as is recommended for normally located breast tissue. The patient should also be evaluated for possibility of kidney and urinary tract malformations.

Granulomatous Mastitis: Unusual Presentation and Management, Experience at Birdem General Hospital

Tuberculosis of breast is an unusual presentation of extrapulmonary tuberculosis. It occurs mostly in women who are of reproductive age group, multiparous and lactating. Common presentation is tumor like but patients of our study group mostly presented with abscess and mastitis. This study was carried out at BIRDEM GENERAL HOSPITAL, ShegunBagicha, Dhaka. Retrospective data of 9 patients with breast tuberculosis was analyzed. Information about demographic details, clinical presentation, cytology, histopathology, comorbidity and management was taken into account. Out of 1202 patients who presented with breast problem during the study period only 9 (0.75%) suffered from tuberculosis of breast. Their age ranged from 20 to 55 years. All patients except 2 presented with abscess formation, 1 with lump and 1 with multiple sinuses. All patients were subjected to histopathology. Their pathological examination showed chronic granulomatous inflammation with caseous necrosis and langerhans giant cells suggestive of tuberculosis. All 9 patients were treated with Anti TB drug therapy after adequate surgical intervention when required. The rare entity tubercular mastitis is a disease of relatively younger age group. Though the usual presentation is tumor like, the patients of the study group mainly presented with abscess formation. Diabetes might be a contributing factor for the unusual presentation among the patients of my study group.Medicine Today 2018 Vol.30(2): 78-80

Tuberculosis of the Female Breast: A Case Report

Tuberculosis of the Female Breast: A Case Report

Primary tuberculosis of female breast: A study of 100 cases

Primary tuberculosis of female breast: A study of 100 cases

Tuberculosis of breast: an Indian scenario

Background: Tuberculosis of breast is quite rare in relation to all breast pathology that we encounter in our daily practice. Ever since it was first described in 1829 many reports have been published. There has been an increasing incidence since the resurgence of AIDS.Methods: This study was done to see the incidence, presentation and investigative modality of tuberculosis of breast in our hospital.Results: A total of 986 patients out of which 585 were fibrocystic breast disease, 238 were malignant, 84 cases presented as abscess, followed by 45 cases as galactocele. 34 cases were diagnosed as tuberculosis of breast. Presentation of tuberculosis of breast was lump 19cases. 9 cases presented as abscess of breast, 4 cases had discharging sinus out of which 2 had developed them after being operated elsewhere for benign breast lump and abscess. Core needle biopsy was done in 4 cases with 2 cases coming out to be positive. Incisional biopsy was done on 2 cases which had come with mutilated breasts and they were positive for tuberculosis. 2 patients underwent excision of small lump diagnosed as fibroadenoma on FNAC, which came out as tuberculosis on biopsy. FNAC of the axillary lymph node showed a positivity rate of 43%. 9 cases were negative.Conclusions: Thus, breast lesions has to be dealt with carefully keeping in mind tuberculosis of breast, as it is a potentially curable disease and we can avoid a lot of morbidity if we can diagnose and start early ATT.

Breast tuberculosis in men: A systematic review.

SettingBreast tuberculosis in male is a rarely reported and poorly described condition.ObjectiveTo quantify the number of breast tuberculosis in men, to describe clinical presentation and to present the diagnostic and therapeutic procedures applied.DesignA systematic review of the literature including reports published in English, Spanish and French until December 2017.ResultsThe search yielded 26 cases of male breast tuberculosis, median age 56.5 years. Most presented with an isolated breast lump (89%), associated with axillary lymphadenitis (27.8%) and skin inflammation (33.3%). The most common constitutional symptoms were pain (64.7%) and fever (35.3%). Fine-needle aspiration cytology and culture were the most common diagnostic modality (61.5%). Standard anti-tuberculosis regimen was the main treatment, alone or accompanied or preceded by incision and drainage.ConclusionsThe risk of breast tuberculosis in men appears to be low, but the condition can be difficult to diagnose and the diagnostic delays can be long. Overall prognosis is good following standard anti-tuberculosis regimen with or without incision/drainage.

Diagnostic challenges of tubercular lesions of breast.

INTRODUCTION:Tuberculosis (TB) in the developing countries presents with both pulmonary and extrapulmonary manifestations. Breast TB, however, remains a rare presentation. Its importance lies in the fact that it may mimic malignancy or present as inflammatory lump/abscess.AIMS AND OBJECTIVE:The aim of the present study is to highlight the importance of breast TB and its diagnostic challenges.MATERIALS AND METHODS:It was a retrospective study conducted at a tertiary care hospital, over 2 years between 2013 and 2015 during which eight cases of breast lesions were diagnosed as of tubercular origin.RESULTS:Granulomas were seen in five cases while three cases revealed only few epithelioid cells, and necrosis was seen in all cases on fine-needle aspiration cytology. Histopathological evaluation was available in six out of the eight cases, while acid–fast bacilli were positive in three cases, the characteristic granulomas were seen in all the six cases evaluated.CONCLUSION:Significance of TB breast lies in the fact that it may masquerade as breast malignancy or pyogenic abscess. India is a developing country where TB is endemic, a high index of suspicion should be expressed in evaluating breast masses, and TB should be considered in the differential diagnosis.

Tuberculosis of Breast: Case Report

Tuberculosis of Breast: Case Report

Breast tuberculosis: clinical spectrum, diagnostic dilemmas and management

Background: Tuberculosis breast is a less known form of extrapulmonary tuberculosis. It poses diagnostic difficulties and confused with breast carcinoma and pyogenic abscess. Objective of the study was to determine the varied presentations of breast tuberculosis, diagnostic difficulties and surgical treatments.Methods: Study was conducted in Department of Surgery at Shri Guru Ram Rai Institute of Health and Medical Sciences, Dehradun, Uttarakhand, India. 651 patients with breast diseases over two years from September 2015- August 2017 were seen at the institution out of which 31 clinically diagnosed patients of breast tuberculosis, confirmed by laboratory work-up, were included in this study. Information regarding demographic details, clinical presentation, cytology, histopathology and management was noted.Results: All patients were females with mean age of 32.5years and out of them 15(48.38%) patients were having breast abscess, 10(32.25%) presented with lump breast and 6(19.35%) with lump with multiple draining sinuses and scars. 27(87.1%) patients had primary breast tuberculosis. Histopathology and TB-PCR reliably helped in diagnosing the disease.Conclusions: The presentation of breast TB is variable, and diagnosis is usually delayed. It should always be kept in mind as differential diagnosis of breast lump and pyogenic abscess. The disease can be diagnosed through pathological tests and a high suspicion. The definite treatment is adequate anti-tuberculosis chemotherapy and surgical excision or drainage especially in recurrent abscesses.

Paradoxical reaction in male breast tuberculosis

Paradoxical reaction in male breast tuberculosis

Breast tuberculosis: a report of five cases

BackgroundBreast tuberculosis is a rare form of extrapulmonary tuberculosis with clinical and radiological misleading presentations. We report herein a retrospective study of clinicopathological features of five cases of breast tuberculosis collected at Hassan II University Hospital of Fès, Morocco, a country where tuberculosis is endemic.Case presentationThe mean age was 40.6 years (range of 21–59 years). Two patients presented with abscessed lesions, and three cases presented with breast lumps with a suspicion of malignancy on imaging techniques. The diagnosis has been made on histological specimens (3 biopsy specimens, 1 excisional biopsy, and 1 lumpectomy). All patients have been successfully treated after the completion of the standard antibiotherapy.ConclusionsOur current study shows that the breast is rarely affected by tuberculosis even in endemic area. The clinical presentation is often misleading, and the histopathological analysis constitutes a valuable diagnostic tool. The prognosis of breast tuberculosis is good after treatment by a standard antibiotherapy.

Tuberculosis of breast: a rare case report

Tuberculosis of the breast is an extremely rare extra pulmonary presentation of tuberculosis accounting for less than 1% of all diseases of the breast. It usually affects young lactating multiparous women, although it may also be reported in prepubescent males, or in elderly women. This rare condition can pose diagnostic difficulties and can mimic carcinoma breast or abscess. We report a case of a 42-year-old female patient with breast tuberculosis. We have reviewed this case in terms of clinical presentation, investigations, surgical treatment and antituberculous therapy and have shortly described our experience. Ultrasonography of breast, mammography and magnetic resonance imaging of breast supported the diagnosis of tuberculosis of breast. Wide local excision of the breast lump was done, and the excised specimen was sent for histopathological examination which confirmed the diagnosis of tuberculosis of breast. Antituberculous therapy was started post operatively. Post-operative period was uneventful. No active breast or pulmonary disease was present one year after surgery in chest computerized tomography scan. Possibility of this condition should be kept in mind in cases of breast carcinoma or abscess. Diagnosis is made by assessing a combination of clinical, radiological and pathological features. Treatment is mainly antituberculous therapy. Surgery is rarely required. A regular follow up is recommended to rule out recurrence of tuberculosis.