Despite being a rare disease, breast tuberculosis poses serious problems because of its unusual symptoms. Many people might not be aware that tuberculosis can cause repeated and numerous abscesses in the breast, leading to misdiagnosis and delays in appropriate treatment. This condition, although uncommon, requires heightened awareness among doctors to prevent complications and ensure positive patient outcomes.
Early detection and treatment are crucial to managing this challenging illness effectively. Breast TB often mimics other breast conditions, making it essential to differentiate it accurately through a combination of clinical evaluation, imaging studies, microbiological tests, and histopathological examination, says Dr Rohan Khandelwal, lead consultant and head of the Breast Centre at CK Birla hospital, Gurugram. He says that a thorough understanding of these diagnostic techniques, coupled with timely intervention can significantly improve patient prognosis.
Raising awareness and advancing medical knowledge about breast tuberculosis are key to improve diagnosis and treatment strategies.
Understanding breast tuberculosis
Due to its rarity, breast TB is a dangerous but uncommon illness that frequently receives the incorrect diagnosis. Patients often report with recurrent abscesses, so it is important that physicians rule out tuberculosis as a possible cause, says Dr Khandelwal. Because breast TB is rare, it is frequently misdiagnosed or disregarded. A thorough treatment strategy that includes medicinal therapy and, in certain situations, minor surgical procedures, can be implemented when an early and precise diagnosis is made.
Differentiating breast tuberculosis from other conditions
Differentiating breast TB from other illnesses that show similarly, like idiopathic granulomatous mastitis, is a major diagnostic difficulty. This common ailment in North India also manifests as abscesses, but the treatment strategy needs to be different. Distinguishing idiopathic granulomatous mastitis from breast tuberculosis is another difficulty we encounter. Steroids are needed to treat idiopathic granulomatous mastitis, but anti-tubercular drugs are used to treat TB. Thus, before starting steroid medication, it is imperative to rule out tuberculosis and other possible cancers, says Dr Khandelwal.
Diagnostic techniques and tools
A combination of clinical assessment, imaging examinations, microbiological testing, and histological inspection is required for an accurate diagnosis of breast tuberculosis.
Clinical evaluation: The initial steps involve a comprehensive patient history and physical examination. Individuals who have breast TB may also have systemic symptoms such as fever, weight loss, and night sweats, or they may have a history of TB exposure.
Imaging studies: Ultrasonography and mammography are frequently used to evaluate breast abnormalities. These imaging methods assist in detecting questionable areas that need more research, even though they cannot conclusively diagnose tuberculosis.
Microbiological tests: To take tissue samples, one can use core needle biopsy or fine-needle aspiration (FNA). After that, Ziehl-Neelsen staining and culture are performed on these samples to determine the presence of Mycobacterium tuberculosis.
Histopathological examination: A biopsy can reveal granulomatous inflammation, which is characteristic of TB. PCR (polymerase chain reaction) tests can also detect TB DNA in tissue samples, providing a more definitive diagnosis.
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