Tuberculous Mastitis And Axillary Lymphadenitis Coexisting With Invasive Ductal Carcinoma Breast

Abstract

While the simultaneous occurrence of tuberculosis in lymph nodes with invasive breast carcinoma is rare, classical tuberculosis manifesting in the breast along with carcinoma and involving particularly the axillary lymph nodes is exceedingly rare, even in developing countries like India where it is an endemic disease. Careful sampling is essential for accurate diagnosis, particularly the areas of extensive necrosis and the therapy regimens for these cases need to be evaluated. Further, axillary lymph nodal status upstaging the clinical diagnosis may prove to be granulomatous lymphadenitis histopathologically. Our case presented with infiltrating ductal breast carcinoma, with tuberculous mastitis and axillary lymphadenitis observed on histopathological study with no evidence of tuberculosis elsewhere, a possibility to be kept in mind by all clinicians. Maintaining a high index of suspicion remains key to the correct diagnosis and therapeutic regimes, particularly in persons hailing from lower socioeconomic strata and having the known risk factors when presenting with invasive carcinoma breast, considering that there are no pathognomic clinical signs or symptoms. Chemotherapy along with antituberculous therapy, however, remains a challenge in these cases.