Breast tuberculosis

Breast tuberculosis is relatively rare in clinical practice. It mainly occurs when pulmonary tuberculosis, intestinal tuberculosis, or mesenteric lymph node infection spreads to the breast through the blood and causes the disease. The clinical manifestations are one or more nodules in one or both breasts. They are painless in the early stages, have unclear boundaries when touched, and may adhere to surrounding tissues. It may become purulent and ulcerate, affecting the surrounding tissues and mucous membranes. The disease progresses slowly and may be accompanied by low fever, night sweats, and swollen axillary lymph nodes.

Western medicine treatment of breast tuberculosis

1. Increase nutrition and pay attention to rest.

2. Systemic anti-tuberculosis treatment: Combined treatment with rifampicin, ethambutol, pyrazinamide, streptomycin and isoniazid. Systemic treatment needs to be performed before and after surgery.

3. If the lesion is confined to one place, the lesion can be removed; if the area is large, simple mastectomy can be performed, and enlarged lymph nodes on the affected side can be removed as well.

4. Patients with primary lesions still need to continue anti-tuberculosis treatment after surgery.

TCM treatment of breast tuberculosis

1. Initial stage of breast tuberculosis: deficiency of lung and kidney yin, liver depression and phlegm stagnation

Main symptoms: One or several lumps in the breast, of varying sizes, with unclear boundaries, hard but not firm, movable when pushed, with unchanged skin color, no pain or slight pain. The tongue coating is thin white and the pulse is stringy and slippery.

Treatment principle: Soothe the liver and relieve depression, nourish yin and resolve phlegm.

Prescription: Kaiyusan combined with Xiaopiwan with modifications. Bupleurum, Angelica, White Peony Root, Atractylodes, Poria, Cyperus rotundus, Curcuma, White Sinapis, Roasted Licorice, Scrophularia, Calcined Oyster Shell, Fritillaria cirrhosa, etc. Please follow the doctor's instructions for specific medication.

Usage: Decoction in water, 1 dose per day, twice a day.

External treatment: Apply Yanghe Jie Ning Paste mixed with Guishe Powder.

2. Breast tuberculosis purulent stage: deficiency of vital energy and toxicity

Main symptoms: The lump gradually grows larger, the skin and flesh are connected, the skin is not red or is slightly yellow, the lump becomes soft, and an abscess is formed, which often affects the chest, flanks, and armpits. The tongue coating is white or yellow and the pulse is rapid.

Treatment principle: Strengthen the body and drain pus

Prescription: Toli Xiaodu Powder with added ingredients. Codonopsis pilosula, raw astragalus, angelica, chuanxiong, white peony root, honeysuckle, atractylodes, poria, sapodilla thorn, platycodon, cyperus rotundus, pangolin, etc.

Usage: Decoction in water, 1 dose per day, twice a day.

External treatment: If the movement is obvious, it is advisable to make an incision and drain the pus.

3. Post-ulceration stage of breast tuberculosis: Yin deficiency and hyperactivity of fire type

Main symptoms: After the abscess ruptures, the pus is clear and thin, forming one or several ulcers, the dead flesh does not fall off, the sores are insidious or form sinus tracts, which are difficult to retract. Accompanied by hot flashes, night sweats, loss of appetite, red tongue with little bitterness, and weak pulse.

Treatment principle: nourishing yin and clearing away heat

Prescription: Liuwei Dihuang Decoction with modifications. Some ingredients including raw Rehmannia root, mountain yam, yam, peony bark, Poria cocos, Alisma orientalis, Artemisia annua, turtle shell, Bupleurum chinense, and Lycium bark.

Usage: Decoction in water, 1 dose per day, twice a day.

External treatment: drainage with 82dan medicine thread, red oil ointment, and fresh flesh after the rotten flesh falls off. Switch to Shengji Powder and Shengji Yuhongqing. When a sinus is formed, insert the Baijiangdan or Hongshengdan medicine stick into the sinus. After the pus is gone, switch to Shengjisan.