Breast Cancer or a Rear Diagnosis

Tuberculosis (TB) and its diagnosis are of great importance in the middleeast, according to the increasing burden of this disease and the large number of unreported cases. Less than 20% of all TB cases only have extra-pulmonary manifestations and breast TB is a rare form of extra-pulmonary TB. It includes about 1% of all breast lesions.
This study presents a breast TB case, which was an 83 year-old woman who that complained of fatigue, lethargy, and fever. In the physical examination, the patient had a discharging abscess in upper outer quadrant of her right breast associated with edema and erythema, accompanied with multiple axillary and supraclavicular adenopathies. Imaging showed multiple cervical, axillary, and abdominal adenopathies.
Clinical manifestations were highly suggestive of inflammatory breast carcinoma. Further investigations, including lymph node biopsy and Polymerase Chain Reaction (PCR) helped with the diagnosis of TB in the patient. The patient was treated with quadruple therapy of TB.
Because of its nonspecific clinical features, TB mastitis is often being misdiagnosed and underreported. Early diagnosis of breast TB could reduce patient's morbidity and also facilitate an effective treatment of patients with inflammatory breast lesions. TB should be the first differential diagnosis of granulomatous mastitis.