Imaging of tuberculous disease involving breast

The aim of our study was to evaluate radiologic findings of the tuberculosis involving breast. We evaluated the radiologic features of 17 patients (18 lesions) with tuberculous disease involving the breast. The radiologic examinations, including mammography (16 patients), ultrasonography (12 patients), and Gd-DTPA-enhanced dynamic MRI (6 patients), were analyzed. Mammographic findings included mass (12 of 17 lesions), calcification (3 of 17 lesions), asymmetric density with spiculated margin (5 of 17 lesions), and axillary lymph node enlargement (8 of 17 lesions). On ultrasonography, a smooth bordered mass (7 of 13 lesions) with thin boundary (7 of 13 lesions) and heterogeneous, intermediate internal echoes (9 of 13 lesions) were most commonly demonstrated. On Gd-DTPA-enhanced dynamic MRI, 3 lesions showed significant enhancement at the first minute after injection (3 of 7 lesions). The maximum enhancing amount was greater than 500 normalized units, and the enhancing pattern was smooth or irregular ring appearance. Breast involvement with tuberculosis is rare but should be considered in the differential diagnosis of a woman living in an endemic area or when extramammary foci of tuberculosis are present. A multimodality imaging approach with clinical evaluation will help to establish the diagnosis of tuberculosis involving breast.