title: Spectrum of breast tuberculosis.
abstract: OBJECTIVE
  To determine the presentation of breast tuberculosis, diagnostic methods and surgical treatments.
  
  
  METHODS
  A case series.
  
  
  METHODS
  This study was conducted at Dow University of Health Sciences and Tuberculosis Clinic at Bantwa Hospital, Kharadar, Karachi, from April 1999 to March 2007.
  
  
  METHODS
  Clinically diagnosed patients of breast tuberculosis, confirmed by laboratory work-up, were included in this study. Detailed history and examination of both breast and axillae were the primary diagnostic measures. Complete blood counts, ESR, Mantoux test, ultrasound, mammogram, fine needle aspiration cytology, staining for acid-fast bacilli both smear and culture were performed. Core biopsy for lumps more than 5 cm and wide excision biopsy for the lump less than 5 cm were the methods applied. Pre-designed research proforma was filled and descriptive statistics of age, site, side, clinical presentations, investigations were recorded and surgical treatment done. Anti-tuberculosis treatment was given to all patients.
  
  
  RESULTS
  Thirty patients were studied with mean age of 28.4 years ranging from 16-48 years. Bilateral breast involvement was seen in 2 patients with 14 cases involving the right and left breast. Lymph node involvement was present in 7. Pulmonary tuberculosis was seen in 4 patients. Multifocal disease was present in 27 patients. The clinical presentation was with lump in 6, discharging sinuses in 14, cold abscess in 8, and non-healing ulcer in 2 patients. There were 5 lactating mothers. Montoux test was positive in 5, AFB smear and culture were positive in 3. Only AFB culture was positive in 4. Five patients required core biopsy for diagnosis of confirmation of lump more than 5 cm and wide excision biopsy was required in 7 patients with lump less than 5 cm. Despite antituberculous treatment, surgical management was required in 21 (70%) cases.
  
  
  CONCLUSIONS
  Tuberculosis of the breast, simulating the carcinoma breast and granulomatous mastitis very closely and are difficult to be differentiated without tissue diagnosis. Surgical management is more often required.
authors.affiliation: Department of Surgery, Dow University of Health Sciences, Civil Hospital, Karachi. drshahishakeel@yahoo.com
authors.forename: Shahida Parveen
authors.initials: SP
authors.lastname: Afridi
authors.forename: Aisha
authors.initials: A
authors.lastname: Memon
authors.forename: Shafiq Ur
authors.initials: SU
authors.lastname: Rehman
authors.forename: Asif
authors.initials: A
authors.lastname: Memon
authors.forename: Noshad
authors.initials: N
authors.lastname: Baig
mesh_terms: D000293:Adolescent; D000328:Adult; D001941:Breast Diseases / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D014376:Tuberculosis / Q000175:diagnosis / Q000601:surgery