Abstract:
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To determine the aetiological types of granulomatous
disease of the breast in women presenting
with mammary complaints in the Sudan.
METHODS: Clinical history and physical examination,
complete blood counts, Mantoux test, histopathology
and fine needle aspiration cytology (FNAC).
RESULTS: Granulomatous mastitis was seen in 11/2500
(0.44%) patients with mammary disease over a 10-year
period. All were of childbearing age (mean 26.0 5.9
years). Common presentations were diffuse swelling,
well-circumscribed masses, nipple retraction, multiple
sinuses and superficial skin ulcers. Lymphadenopathy
was seen in more than 60% of the patients. Diagnosis
was based on cytomorphological features in 10/11 cases
and histopathology in one. Nine were diagnosed with
tuberculous mastitis and two with idiopathic granulomatous
mastitis. Acid-fast bacilli (AFB) could not be
demonstrated in any of the cytology smears. Tuberculous
mastitis responded to empirical anti-tuberculosis
treatment, with a minimum follow-up of 2 years in seven
women.
CONCLUSION: Tuberculous mastitis is a rare entity in
women with mammary disease in the Sudan. Alternative
diagnoses such as idiopathic granulomatous mastitis
should be made only after failure of an adequate trial of
anti-tuberculosis treatment. FNAC is a useful diagnostic
tool even if AFB cannot be demonstrated. |