Tuberculous mastitis: a disease not to be forgotten

To present our experience with tuberculous mastitis to increase the awareness of surgeons, pathologists and radiologists about this rare disease.

Records of nine patients with tuberculous mastitis were retrospectively reviewed.

Tuberculous mastitis was seen in 0.6% of our patients with surgically treated mammary disease. There were eight females (mean age 32.9 years) and one male. All female patients were parous, two were lactating and one was pregnant. A unilateral breast mass mimicking breast cancer and breast abscess were the presenting feature in seven and two patients, respectively. Two patients had previous pulmonary tuberculosis. Radiological findings were not specific. Fine needle aspiration was performed for seven patients, and excisional biopsy for all patients. The final diagnosis was based on demonstration of acid-fast bacilli in biopsy specimens in two patients, and histopathology aided by polymerase chain reaction in the remaining seven patients. Mastectomy was performed for one patient due to severe breast destruction. All patients had satisfactory results on antituberculosis treatment.

Tuberculous mastitis is a rare entity in patients with mammary disease. A high index of suspicion is the cornerstone for diagnosis. Conservative surgery and anti-tuberculosis drugs seem to be adequate treatment.