Overview
Tuberculosis (TB) of the breast is a rare form of extrapulmonary tuberculosis that may mimic breast malignancy clinically and radiologically. Patients with a history of tuberculosis demonstrate an increased risk of developing subsequent malignancies, necessitating careful diagnostic differentiation between chronic infection and neoplasia 1.Diagnosis
Clinical presentation often overlaps with breast carcinoma, requiring high clinical suspicion in endemic regions 1.
Diagnostic evaluation should prioritize the exclusion of malignancy, as the pooled standardized incidence ratio (SIR) for all cancers is significantly elevated (SIR 1.62) in individuals with a history of TB 1.
The risk of malignancy is highest within the first year following a TB diagnosis (SIR 4.70), suggesting that persistent breast masses in this timeframe require rigorous investigation 1.Special Populations
Individuals with a history of TB are at a significantly higher risk for developing lung cancer (SIR 3.20) compared to the general population 1.
The elevated risk of malignancy persists across the TB-affected population, with the highest incidence observed in the 12 months immediately following the initial TB diagnosis 1.Key Recommendations
Clinicians should maintain a high index of suspicion for malignancy in patients with a history of TB, particularly when presenting with breast masses within the first year of TB diagnosis 1. (Evidence: Moderate)References
1 Luczynski P, Poulin P, Romanowski K, Johnston JC. Tuberculosis and risk of cancer: A systematic review and meta-analysis. PloS one 2022. link