Role of polymerase chain reaction in breast tuberculosis

Breast tuberculosis (TB) is an uncommon condition even in endemic countries. Breast abscess is usually seen in young females. PCR helps in such challenging cases to clinch the correct diagnosis.

The present study was performed to compare FNAC and TB PCR in inflammatory lesions of breast.

FNAC cases reported as breast abscess, necrosis, non-specific and granulomatous inflammation on cytology was taken. The material for PCR was obtained from archived MGG smears and PCR for Mycobacterium tuberculosis for insertion sequence IS6110 was performed.

A total of 54 cases were studied. The age ranged from 19-55 years. On FNAC, acute suppurative inflammation without granulomas and negative AFB staining was noted in 18 cases; granulomatous inflammation/mastitis in 26 cases and granulomatous inflammation with necrosis with AFB positivity confirming tuberculosis in 10 cases. PCR for Mycobacterium tuberculosis for insertion sequence IS6110 was performed. None of the 18 cases of acute suppurative inflammation had positivity for PCR. 13/26 [53.3%] cases of granulomatous inflammation/ mastitis with AFB negativity were positive for PCR. 10/10 cases of granulomatous inflammation with necrosis with AFB positivity showed PCR positivity. Therefore, proven cases of TB after FNAC were only 10/54 [17.24%] and the sensitivity increased to 23/54 [42.6%] after performing PCR on FNA aspirate.

PCR helped in identifying 13/26 [50%] cases reported as granulomatous inflammation on cytology as tuberculosis. FNAC acted as an efficient modality for collection of material for PCR. This study shows how PCR aids in diagnosis of breast TB.