Tuberculous mastitis: A masquerading face of granulomatous mastitis

Tuberculosis (TB) mastitis is a rare form of granulomatous mastitis. We aimed to evaluate the clinical characteristics and prognosis of patients diagnosed with TB mastitis.

A descriptive study was carried out on patients who were reported to national tuberculosis control authorities as having TB mastitis between 2003 and 2021. Demographic, histopathological, and radiological data including mammography, ultrasonography (US), and magnetic resonance imaging (MRI) were reviewed. All were followed up to 24 months and prognosis was also evaluated.

This study identified 29 TB mastitis patients who had been diagnosed using excisional biopsies. The mean age was 33.5 ± 10.1, all were premenopausal women. The most common symptom was breast mass (n= 24, %82.8), nearly half of the patients also had ipsilateral axillary lymphadenopathy (n= 14, 48.3). One-fourth of the patients had bilateral involvement (n= 7, 24.1%), and half of the patients (n= 16, 55.2%) presented with multiple masses. One patient had co-existing pulmonary TB. Predisposing factors for TB were not identified in any of the patients. Nearly half of the patients received prior mastitis treatment. The most common radiological finding was mass in both mammography and US. All patients received anti-tuberculosis treatment of a standard regimen for six to 21 months, three patients had a relapse but were finally cured.

TB mastitis should be suspected in young and premenopausal women presenting with a breast mass and axillary lymphadenopathy in an endemic region. Radiological findings could not identify the diagnosis. A multidisciplinary approach including bacteriology and histopathology should be performed. Anti-tuberculosis treatment can be implemented successfully.