Coexistence of breast cancer and tuberculosis in axillary lymph nodes: a case report and literature review

Coexistence of breast cancer and tuberculosis (TB) of the breast and/or axillary lymph nodes is uncommon. In this article, we present a case of tuberculous axillary lymphadenitis existing simultaneously with invasive ductal carcinoma of the left breast. We also conducted an extensive literature review of English language studies published on the coexistence of breast cancer and TB of the breast and/or axillary lymph nodes from 1899 to 2011 using the PubMed and Google Scholar databases. Twenty-nine cases of coexisting breast cancer and TB of the breast and/or axillary lymph nodes have been published to date, including a 74-year-old female diagnosed with left breast cancer and TB of the axillary lymph nodes. A tumor in the right breast was detected in 14 patients and in the left breast in 12 patients between the ages of 28 and 81 years, but no data were available regarding the side on which the tumor occurred in three patients. Eighteen patients underwent a modified radical mastectomy, five patients underwent a radical mastectomy, two a lumpectomy and an axillary lymph node dissection (ANLD), two a quadrantectomy (Q) and an ALND, and two an applied excision. TB was detected at the axilla in all 21 patients in patients with no TB of the breast, and TB was also detected in the axilla in five of eight patients with breast TB. Both a tumor and TB lymphadenitis were detected following an axillary dissection in 14 patients, and both cancer metastasis and TB lymphadenitis were detected at the same lymph nodes in six of these patients. The simultaneous occurrence of these two major illnesses in the breast and/or axillary lymph nodes can produce many problems with respect to diagnosis and treatment. Accurate diagnoses are necessary for down-staging carcinoma of the breast and for identifying curable disease.