Tuberculous mastitis: A masquerading face of granulomatous mastitis

Introduction: Tuberculosis (TB) mastitis is a rare form of granulomatous mas-titis. We aimed to evaluate the clinical characteristics and prognosis of patients diagnosed with TB mastitis.Materials and Methods: A descriptive study was carried out on patients who were reported to national tuberculosis control authorities as having TB masti-tis between 2003 and 2021. Demographic, histopathological, and radiological data including mammography, ultrasonography (US), and magnetic resonan-ce imaging (MRI) were reviewed. All were followed up to 24 months and prognosis was also evaluated.Results: This study identified 29 TB mastitis patients who had been diagnosed using excisional biopsies. The mean age was 33.5 +/- 10.1, all were premeno-pausal 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 rece-ived prior mastitis treatment. The most common radiological finding was mass in both mammography and US. All patients received anti-tuberculosis treat-ment of a standard regimen for six to 21 months, three patients had a relapse but were finally cured.Conclusion: TB mastitis should be suspected in young and premenopausal women presenting with a breast mass and axillary lympha-denopathy 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.