Mammary Tuberculosis: A Cause of Lump in the Breast

Abstract

Background: This study was conducted to highlight the importance of mammary tuberculosis, by determination of its frequency, clinical presentation and laboratory investigations in our set-up. Material and Methods: It was a retrospective study performed at Department of Pathology, Nawabshah Medical College, Nawabshah. The data was collected from the file record of these patients from January 1997 to December 2006 and the results were tabulated. Results: Nine cases of tuberculosis were diagnosed in 396 lumpectomy/mastectomy specimens. Age of these patients ranged from 18 to 42 years. All were married women belonging to poor socio-economic class, bearing on average five children. One patient was pregnant and three lactating mothers. Associated pulmonary tuberculosis was present in three cases. Previous history of tuberculosis was present in one case and history of tuberculosis in the family was seen in five cases. Mass with or without ulceration /abscess / discharging sinus was the clinical presentation in all the cases. Axillary lymphadenopathy was seen in five cases. Fever and pain with history of weight loss was seen in all the cases. All the patients were found to be anaemic with high erythrocytes sedimentation rate. The total leukocytes count ranged from 4.2 - 7.2 x 109/l. Mantoux test was positive in all the cases. Acid fast bacilli in the breast tissue were seen in only one case. The diagnosis was made on histological grounds by the presence of chronic granulomatous inflammation with caseating epithelioid granulomas and Langhan’s type of giant cells. Conclusion: The frequency of tuberculosis in our study is 2.3% in the patients with lump in the breast. Doctors should keep tuberculosis in the differential diagnosis of breast lump.