Syed Qaiser Hussain Naqvi, Jan Muhammad Memon, Anwar Ali Akhund, Tabinda Taqi.
Tuberculosis of the breast: a cytomorphological study of nine cases.
Pak J Surg Jan ;23(4):237-41.

Objective: To determine the role of FNAC with histological confirmation in the diagnosis of tuberculous mastitis, and to highlights its importance by determination of frequency, clinical history, clinical presentation and laboratory investigations in our setup. Design Duration: A retrospective case series from Jan. 1997 to Dec. 2006. Setting: Department of Pathology, Nawabshah Medical College, Nawabshah. Patients: Nine patients with mammary tuberculosis. Methodology: The data was collected from patients files and other record, and the results tabulated. Results: All were married multiparous women, aged 18-42 years, belonging to poor socio-economical class. One was pregnant, while three were lactating mothers. Associated pulmonary tuberculosis was present in three cases. Previous history of tuberculosis was present in one case, though five patients had a family history of tuberculosis. Lump in the breast, with or without ulceration/ abscess/ discharging sinus was the clinical presentation of all the cases, as was low grade fever and pain. All patients had anemia and weight loss, though axillary lymphadenopathy was seen in five cases. ESR was raised in all the cases and the Mantoux test was positive. The glutaraldehyde test was positive, though it was performed in three cases only. AFB were seen in one case only. The diagnosis was made on FNAC by the presence of chronic granulomatous inflammation having caseating epithelioid granulomas and Langhan`s type of giant cells. The cytological diagnosis was confirmed by histopathologicaI findings of excisional biopsy specimen in all the cases. Conclusion: The present study highlights the importance of tuberculous mastitis; its frequency being 2.3% in breast diseases. FNAC is an important initial diagnostic tool in patients having tuberculous mastitis, specially in the rural areas. It is safe, rapid, simple, cost effective and accurate, the accuracy being 100%.

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