Mumbai: Breast TB on the rise, says medical experts

All lumps in the breast are not cancerous say surgical oncologists who are seeing an increase in breast tuberculosis TB cases among young professionals and elderly women Experts worry that this is being underreported due to a lack of awareness and delay in diagnosisDr Meghal Sanghavi a surgical oncologist at Wockhardt Hospital in Mumbai Central said ldquoOver the past few months breast TB cases have come to light In most cases there was a delay in diagnosis and subsequent line of treatment as patients would presume it to be an infection which was not the caserdquoDr Meghal Sanghavi surgical oncologist Wockhardt Hospital Mumbai CentralAccording to Dr Sanghavi the TB bacterium easily infects those who have low immunity and poor nutrition She referred to a case of a patient in her midthirties a working professional with erratic food habits ldquoHer nutrient intake was insufficient and she was also diabetic A lump on her breast went almost undiagnosed for a few months and with multiple lines of treatment before she was diagnosed with breast TB She was put on antibiotics which gave her temporary relief during the initial period but tuberculosis went undetectedrdquoAlso Read No divorce for man who falsely claimed his wife was HIV positive Bombay High CourtDr Sanghavi added ldquoTaking antibiotics before the actual diagnoses of the ailment may act as secondline therapy for TB and they partially work on the bacteria which gives a false sense of healing And as antibiotics are not prescribed for over a period of five week the bacteria once again comes active with the stoppage of antibiotics and it spreads unless the patient is put on AKT treatment for tuberculosis which varies from six to nine monthsrdquoOncologists are seeing cancers associated with tuberculosis in nodes in the neck or armpit Representation picThis was the case with Dhara Jain 35 a law graduate and company secretary from Byculla who learnt this the hard wayShe told midday ldquoI had a lump in my breast which was diagnosed for the first time in March 2021 It started as a small boil but it soon became very painful and impacted my daily routine I was diabetic and initially most of the physicians and gynaecologists I visited suspected it to be cancerous but all my test reports were negative I had spent over Rs 150 lakh on treating something that was unclear aboutrdquoDr Kedar Toraskar pulmonologist and TB expertldquoIt was my sonologist who first suspected it to be a breast tuberculosis lump and advised me to meet a certain expert who was able to detect and diagnose the ailment correctly I was put on antiTB medicine and being diabetic instead of six months I have been put on treatment for nine months Today I am back to my routine and even playing with my threeyearold child without any hardshiprdquo said JainShe added ldquoI would advise youngsters not to panic and get the correct diagnosis done before pumping your body with antibiotics and to trust that all lumps are not cancerous I am thankful to Dr Meghal Sanghavi and Dr Kedar Toraskar for correctly diagnosing my ailment and treating merdquoAsked what happens if breast TB goes untreated for a long period Dr Sanghavi said it could lead to breast distortion and pain ldquoMoreover the lump can rupture leading to a poorhealing wound and can cause sinus tracts and fistulas which are nonhealing and these infections mainly affect the quality of life and daily routine Also the risk of drugresistant tuberculosis cannot be ruled outrdquo she saidDr Sanghavi added that she had to carry out surgical interventions to treat some patientsrsquo lumps as medicines were not working out directly ldquoWe are also seeing cancer associated with tuberculosis in nodes in the neck region or armpit area and if the node test negative for cancer and positive for tuberculosis we need to treat the patient accordinglyrdquo she saidDr Kedar Toraskar pulmonologist and TB expert said ldquoWith the easy availability of GeneXpert testing and the MGIT mycobacteria growth indicator tube test it has become easy to diagnose TB faster and the pickup rates have increased and it also helps to know if the tuberculosis is drugresistant or drugsensitive and accordingly we can plan the line of treatmentrdquoDr Toraskar added ldquoWe must understand that in India TB is endemic and breast TB usually tends to be around 5 to 7 per cent of all TB cases whereas the same in western countries would be less than 1 per cent The chances of a lactating mother getting a breast infection is high as they are low on immunity The breast is more vascular with more blood supply Also we are seeing cases of malignancy and TB in certain patients Early and correct diagnosis help in faster recoveryrdquoUnderreportingDr Sanghavi quoted the Global Tuberculosis Report dated October 27 2022 which states ldquoWith 28 per cent cases India was among the eight countries accounting for more than twothirds 683 per cent of the total TB patient count India accounted for 36 per cent of global TBrelated deaths among HIVnegative peoplerdquo India was among the three countries that accounted for the most reduction in 2020 67 per cent of the global figure the other two being Indonesia and the PhilippinesrdquoAnother problem is underreporting of cases which is a problem in India the country is among the top five contributors 24 per cent followed by Indonesia 13 per cent the Philippines 10 per cent Pakistan 66 per cent and Nigeria 63 per cent Reductions in reported TB cases suggest an increase in people with undiagnosed TB The report reiterated its call for countries to put in place urgent measures to restore access to essential TB services28Percentage of global TB cases in IndiaImportant indicationsA tuberculosis lump Starts as a small boildefused lump Causes heaviness or pain in breast May liquify or rupture and release pus Is associated with loss of appetite lowgrade fever weight lossA cancerous lump Is painless unless in late stages It is welldefined and hard in consistency May involve the skin but does not liquify Is not be associated with loss of appetite lowgrade fever initially