Tuberculosis of the breast masquerading as carcinoma: a study of 100 patients.
One hundred patients with tuberculous mastitis were referred to the Tata Memorial Hospital, a cancer center, with a clinical diagnosis of malignancy. This study identifies the possible causes of misdiagnosis and reviews the management of these patients. A lump in the breast with or without ulceration was the commonest presentation, the others being diffuse nodularity and multiple sinuses. Concomitant axillary lymph nodes were found in one-third of the patients. Tuberculosis lesions such as nodular mastitis, disseminated mastitis, and sclerosing lesions clinically mimicked a fibroadenoma, carcinoma, and fibrocystic mastitis depending on the mode of presentation. A young, multiparous, lactating woman with a lesion should arouse the suspicion of tuberculous mastitis, although pretherapeutic pathologic confirmation of a benign disease is mandatory. Mammography, fine-needle aspiration cytology, and excision biopsy for this purpose are successful in 14%, 12%, and 60% of cases, respectively. Acid-fast bacilli were identified in 12% patients. All patients received antituberculous chemotherapy, and 14% patients required simple mastectomy, due to either lack of response to chemotherapy (10%) or large painful, ulcerative lesions involving the entire breast (4%). Axillary dissection was performed in only 8% patients with large ulcerated axillary nodes. All patients, followed for a minimum of 2 years, were free of disease after therapy.
Shinde
S R
SR
Department of Surgical Oncology, Tata Memorial Hospital, Parel, Bombay, India.
Chandawarkar
R Y
RY
Deshmukh
S P
SP
D000293:Adolescent; D000328:Adult; D001365:Axilla; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000175:diagnosis; D018567:Breast Neoplasms, Male / Q000175:diagnosis; D002277:Carcinoma / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008327:Mammography; D008413:Mastitis / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D008875:Middle Aged; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery