Background: Tuberculous mastitis is a rare clinical entity and it often resembles breast malignancy and pyogenic breast abscess both radiologically and clinically. It usually affects females from the Africa and Indian sub-continent.

Aim: To find out the clinical feature, diagnostic criteria and need for surgical intervention in tuberculous mastitis.

Methods: Patients with clinical suspicion of breast tuberculosis were subjected to a set of investigations for confirmation and were included in the study. The main diagnostic measures were thorough history and examination. All were subjected to complete blood examination, ESR, Monteux test, ultrasound (for patients aged<40 years), mammogram (for patients aged>40 years), fine needle aspiration cytology andAFB staining. Abscesses were aspirated, lumps greater than 2cm were subjected to true cut biopsy and less than 2cm were excised and histopathology performed on the specimen. Data was recorded in a predesigned proforma and parameters like age, site, size, mode of presentation etc., were recorded along with need of surgical intervention.

Results: 264 patients were included with mean age of 31.4.23 patients had bilateral disease. Primary disease was found in 162 patients and secondary in 102. Multifocal disease was found in 45. Mode of presentation was discharging sinus in 115, lump in 61, cold abscess in 60 and non- healing ulcer in 28 cases. Cytology and AFB staining had diagnostic value in 60 cases. Wall biopsy after drainage of abscess 43, true cut biopsy47 and wide local excision biopsy confirmed the diagnosis in 68 patients after the specimen were subjected to histopathology. Even after anti-tuberculous therapy, surgical intervention wasrequired for 171 patients.

Conclusion: Tuberculous mastitis may masquerade malignant lesion of breast and poses diagnostic difficulties without histopathological examination. Surgical intervention may be required.

Keywords: Tuberculous mastitis; discharging sinus; granulomatous mastitis.