[Tuberculosis of the breast: imaging findings in two patients]

Diagnosis of breast tuberculosis is difficult and rare in western countries. We describe two cases of mammary tuberculosis, with mastitis as clinical feature that fail to heal despite antibiotic therapy. Mammographic findings showed a large opacity involving the entire breast in case 1, and a focal asymmetric density with irregular margins in case 2. Sonographic findings revealed in both cases hypoechoic nodules with fistulous tracks and axillary lymph nodes. Magnetic resonance was performed in one case, which showed parenchymal asymmetry with heterogeneous enhancement including irregular internal ring enhancement. Fine needle aspiration cytology revealed inflammatory cells in first case and atypical cells in second case. Core needle biopsy was performed in both cases to rule out malignant lesions. Acid-fast bacilli were negative in both patients while polymerase chain reaction was positive in one case. There was a good clinical response to antituberculosis therapy.