BREAST TUBERCULOSIS PRESENTING AS A LUMP: AN UNCOMMON IDENTITY -A REPORT OF THREE CASES.

Breast tuberculosis is a rare manifestation of extra-pulmonary localization of the disease and accounts for only 3-4% of breast conditions in underdeveloped regions of Asia and Africa with most of the cases seen in women in their reproductive age-groups. We encountered three such cases presenting as breast lump in a 16 year old, 26 year old and 70 year old female respectively. The overlying skin was normal in all the three cases and all of them came positive for Ziehl-Neelsen staining for acid-fast bacilli and were reported as tuberculous lymphadenitis involving intra-mammary lymph node, tuberculous mastitis and tuberculous inflammation respectively. The lump can sometimes be mistaken for breast cancer and pyogenic breast abscess. Fine needle aspiration cytology may not always detect the responsible pathogen but the presence of epithelioid cell granulomas and necrosis gives a clue to the establishment of a definitive diagnosis in upto 73% of the cases. A trial of anti-tubercular therapy with regular clinical assessment is warranted in all such cases.