A tumour in the breast: vaccination granuloma as a differential diagnosis

Aims: Breast cancer is the most frequent type of cancer in women; special attention is therefore paid to tumours in the breast region. Vaccination granuloma is a differential diagnosis of rumours in the upper part of the breast. Methods: All granulomatous lesions in the breast region since 1970 were retrieved from the files of the Departments of Pathology at Odense University Hospital and Svendborg Hospital. Results: Fourteen cases with a histology compatible with vaccination granuloma were found. Eight patients had a known history of tetanus vaccination. The tumours were ovoid, or even rod-shaped, and measured between 8 x 3 mm and 12 x 10 mm. Histologically, there were necrotic foci surrounded by histiocytes, lymphocytes, and plasma cells. Aluminium was detected by staining with solochrome azurine. Conclusions: The possibility of a vaccination granuloma should be kept in mind in patients with a palpable tumour in the upper part of the breast. as well as in mammography screening conditions and in follow-up patients after previous treatment for breast cancer.