A Case Series on GeneXpert Negative Tuberculous Mastitis and the Effect of Anti-tuberculous Treatment

Background: Breast tuberculosis is significant due to its rare occurrence and dilemma in prospective treatment and differentiation from neoplastic lesions. Tuberculosis of the breast usually affects women from Asia, most commonly, the Indian subcontinent and Africa. Tuberculous mastitis has a wide range of clinical presentation, radiological features, and even microbiological presentation. Materials and Method: A prospective study was conducted over 6 months. 40 female patients with varied presentations correlating to tuberculous mastitis with a lump in the breast for a particular period of time were included in the study. Results: The patients’ ages varied from 20 to 45 years. After routine investigations, the patients went in for incision and drainage or incisional biopsy or both and postoperatively their histopathological reports revealed granulomatous breast disease (tuberculous mastitis) with negative GeneXpert (CB-NAAT). Patients were started on an anti-tubercular treatment regimen and showed a progressive decrease in symptomatology. Conclusion: Granulomatous breast abscess/ tuberculous breast abscess has a varied presentation and no fixed treatment regime. Anti-tuberculous drugs in such patients proved to be efficacious in symptomatic relief with prevention of recurrence/ fistula formation.