Yifei Zeng, Dongxiao Zhang, Na Fu, Hao Dong, Yu Zhou

Department of Galactophore, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China

Correspondence: Na Fu, Department of Galactophore, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, No. 23, Art Museum Back Street, Dongcheng District, Beijing, 100010, People’s Republic of China, Tel +86 17862968916, Email qilian0521@126.com

Background: Breast tuberculosis (BTB) is a clinically rare breast disease, and cases of BTB combined with granulomatous mastitis are even rarer. This type of disease is straightforward to misdiagnose or overlook during clinical diagnosis, thereby delaying treatment.
Methods: This case report describes a rare case of granulomatous mastitis complicated by breast tuberculosis in an elderly female patient admitted to the Breast Surgery Department of Beijing Traditional Chinese Medicine Hospital affiliated with Capital Medical University. Through a retrospective analysis of the integrated traditional Chinese and Western medicine treatment process, this study compares the patient’s condition after three follow-up visits following the implementation of a traditional Chinese medicine (TCM) treatment regimen, as well as the six-month post-operative follow-up outcomes. Additionally, by referencing relevant prior literature, this study analyzes and summarizes the current status of diagnostic and therapeutic research on BTB.
Results: In this case, granulomatous mastitis was the first symptom in the early stage, and traditional Chinese medicine soup was taken internally as well as poultices applied externally, with a relatively obvious clinical effect. The diagnosis was confirmed by ultrasound, CT, tissue biopsy, Mycobacterium tuberculosis acid-fast stained smear, and other tests. The patient was treated surgically, and the diagnosis was finally confirmed by molecular testing and anti-tuberculosis treatment in a specialized hospital. The patient’s condition was stable on follow-up, and the prognosis was good.
Conclusion: Early diagnosis and differentiation of breast tuberculosis is difficult, and it is very easy to misdiagnose and delay the disease. In the early stage of the disease, traditional Chinese medicine can be used in combination, and in the stable stage of the disease, a reasonable choice of surgical treatment can shorten the course of the disease. This also reveals the important value of integrated Chinese and Western medicine treatment in the clinical treatment of this type of patient.

Keywords: breast tuberculosis, granulomatous mastitis, misdiagnosis, surgical treatment, traditional Chinese medicine