Right breast invasive carcinoma and contralateral left axillary abscess representing a rare dual pathology

A 53-year-old female patient complained of bilateral breast enlargement with a palpable mass in the left axilla. Contrast-enhanced MRI revealed a suspicious lesion in right breast along with an ill-defined collection in the left axilla. Targeted ultrasound revealed an irregular hypoechoic lesion in the right breast along with collections in the left axilla. FNAC of the lesion in right breast revealed invasive carcinoma, while FNAC of the left axillary swelling yielded purulent material suggesting abscess. Cartridge-based nucleic acid amplification testing (CBNAAT) detected the presence of Mycobacterium tuberculosis complex DNA without resistance to rifampicin. The patient was then given antitubercular treatment. The patient then underwent a wide local excision of the suspicious lesion in the right breast. The histopathological examination revealed Grade 3 invasive carcinoma of no special type (NST). This is a rare case of the coexistence of breast carcinoma along with contralateral tuberculous axillary lymphadenitis, which clinically mimicked metastatic axillary lymphadenopathy. The clinical, radiological and pathological correlation is essential to avoid any misdiagnosis of the tumor.