Synchronous breast carcinoma with ipsilateral axillary tuberculosis, posing a diagnostic dilemma

Area of Science:

• Oncology
• Infectious Diseases
• Pathology

Background:

• Synchronous primary invasive ductal carcinoma and tuberculosis (TB) is an exceptionally rare clinical presentation.
• Accurate diagnosis is crucial for effective management of coexisting malignancies and infections.

Observation:

• A 63-year-old postmenopausal diabetic female presented with a right breast lump and ipsilateral axillary lymphadenopathy.
• Imaging indicated BIRADS V classification for the breast lesion and suspicious lymph nodes.
• Core needle biopsy confirmed invasive ductal carcinoma, while lymph node biopsy revealed caseating granulomatous inflammation consistent with TB.

Findings:

• Histopathological examination is essential for differentiating malignancy from granulomatous inflammation in lymph nodes.
• The patient received a modified radical mastectomy, adjuvant chemotherapy, and antitubercular therapy.

Implications:

• This case emphasizes the need for thorough histopathological evaluation to rule out concurrent infections like TB in breast cancer patients.
• Multidisciplinary management is vital for optimizing treatment strategies and patient outcomes in such complex cases.
• Early and accurate diagnosis of both conditions can lead to successful treatment and complete disease resolution.