Mammographic features of breast tuberculosis: The skin bulge and sinus tract sign

Six cases with bacteriologically and/or histologically proven breast tuberculosis were analysed out of 1152 consecutive mammograms performed. The objective was to identify some factors that may facilitate pre-operative mammographic and ultrasonographic diagnosis of breast tuberculosis. Nipple retraction and coarse stromal texture occurred in all six cases. In five cases there was an ill-defined breast mass, skin thickening, and a reduction in size of the affected breast. A unique finding was a sinus tract connecting the breast density to a localized skin thickening and bulge which occurred in only two cases. Ultrasonography showed cystic masses. The incidence of breast tuberculosis in the studied population was 0.52%. A mammographic demonstration of a dense tract connecting an ill-defined breast mass to a localized skin thickening and bulge (skin bulge and sinus tract sign) is strongly suggestive of tuberculous breast abscess. Change in shape and outline of the breast mass can be seen in the standard breast views.