[Tuberculosis of the breast].

Tuberculosis of the breast is a rare malady. The clinician may confuse tuberculosis of the breast with either carcinoma or breast abscess. In the past 30 years at the First Teaching Hospital attached to Xi'an Medical University, only 23 patients reported herein had documented tuberculosis of the breast. Tuberculosis of the breast is a disease of younger women between 20 and 40 years of age. Mammary tuberculosis may be primary or secondary. There are three recognized modes of spread of the tubercle bacillus to the breast: hematogenous, lymphatic spread, and direct extension. There are three recognized types of mammary tuberculosis: nodular, diffuse, and sclerosing type. The diagnosis of mammary tuberculosis is difficult. The most reliable diagnostic studies include bacteriologic cultures of aspirate, histologic examination of tissue, and guinea pig inoculation. The differential diagnosis includes with carcinoma, acute or chronic mastitis with abscess. The treatment of tuberculous mastitis requires a combination of surgery and antituberculous drugs.