Mammary tuberculosis: rare but still present in the United Kingdom

Mammary tuberculosis (TB) is rare and usually affects women from the Indian sub-continent and Africa. It may be mistaken clinically for carcinoma or pyogenic abscess. Tuberculosis (particularly drug-resistant TB) is on the increase in areas of the UK with rising numbers of immigrants, some of whom may present with breast lesions of uncertain aetiology. Between 1978 and 1997 there were 436 cases of TB notified for Indian Sub-continent females aged 15-49 years in Blackburn, Hyndburn and Ribble Valley, Lancashire, UK. Ten cases were mammary TB (10/436 = 2.3%) which was clinically suspected in only three patients preoperatively, despite the area having large numbers of immigrants. Mammary TB should be included in the differential diagnosis of breast lesions in women from those ethnic groups at increased risk of TB. Pus and/or breast tissue samples should be subjected to TB culture and histological examination for both diagnosis of TB and determination of drug sensitivities.