Reviewer ’s report  
 
Title: Fortu itous discovery of Ganglionic Tuberculosis after conservative treatment of Breast 
Cancer: a case report and review of the literature  
 
Version: 0 Date: 14 Jan 2019  
 
Reviewer: Luc Strobbe  
 
Reviewer's report:  
 
Review of manuscript  
Fortuitous discovery of Ganglionic Tuberculosis after conservative treatment of Breast Cancer: a 
case report and review of the literature  
The authors succeeded in nicely reporting an indeed unusual case of the combination of breast 
cancer and tuberculosis, both as primary diagnosis. Not only in Morocco, Africa, but also in 
Eastern Europe and the greater p art of Asia, surgical and medical oncologists as well as 
pathologists should be aware of the possibility and associated treatment sequence.  
 
"Case presentation"  
However nicely the course of diagnosis and treatment may be painted, it would be suitable to 
limit the narrative to the essential points, necessary for grasping the flow of events in al logical 
way.  
Why was no biopsy of the suspect axillary node performed prior to surgery? That could possibly 
have prevented a negative axillary dissection.  
Definit ive postop staging pT2N0 should be mentioned.  
It is not clear what was the sequence of adjuvant treatment: first 6 months of tuberculostatic 
agents (which kind?), followed by 3 four -weekly (?) courses of FEC100, followed by 3 three -
weekly (?) courses of do cetaxel, followed by irradiation? If so, that makes irradiation started 
nearly one year after primary surgery. Or were tuberculostatic drugs given simultaneously with 
chemo. In that case, what was the interval between operation and start of irradiation?  
 
Some words need revision:  
- What is meant by "intracanalire"? could this be "intra ductal"?  
- The word "benefit" from treatment should not be used. Whether the patient really benefits 
from whatever treatment has to be awaited in the adjuvant setting  
 
"Conclusions"  
Try to limit the sentences and words to the essentials, necessary to confer the message.  
- The paragraph on "breast cancer" can be omitted, given the target audience is supposed to 
be aware of the general information in this paragraph  
 
- Instead comment on alternative approaches of the axilla (literature), the pro's and con's of 
deferring radiation treatment (literature)  
 
- Refrain from subjective sentences as in "the patient is fortunate" (page 5 line 1), "luck"  
The English language needs re vision regarding word choice and syntax as well.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supporte d by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please spe cify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Not suitable for publication unless extensively edited  
  
Decla ration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or l ose financially from the publication of this  
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2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
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