Outcome of Anti-TB Therapy After Excision of Breast Lump

Abstract

Introduction: Granulomatous mastitis (GM) is a rare, chronic inflammatory breast disease often mimicking breast cancer. Tuberculosis (TB) is a major suspected cause, especially in high-prevalence areas. This study evaluates the effectiveness of anti-tubercular therapy (ATT) in managing chronic GM, particularly in cases with sinus formation post-excision, to enhance treatment strategies. Methods & Materials: This cross-sectional study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from January 2022 to January 2024, to evaluate the outcome of anti-tubercular therapy (ATT) in patients diagnosed with chronic granulomatous mastitis (GM) with sinus formation after surgical excision. A total of 100 female patients aged above 18 years, diagnosed with GM, were included in the study. Data were analyzed using statistical software (SPSS version 22.0). Result: In this study of 100 patients with granulomatous mastitis, most patients (73%) showed a complete response to anti-tubercular therapy (ATT), while 18% had a partial response. The majority of patients underwent excision (72%), with fewer requiring partial or total mastectomy. Diagnostic investigations such as USG, mammogram, and histopathology were positive in all cases, confirming the diagnosis. A small percentage of patients experienced recurrence (4%), and the traditional 4FDC regimen was the most commonly used treatment. Conclusion: This study demonstrates that anti-tubercular therapy is effective in the treatment of granulomatous mastitis with sinus formation, with most patients showing a complete response. However, partial responses and recurrences still occur, indicating that further research is needed to identify factors influencing treatment outcomes.