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: 11 Mar 2019  
 
Reviewer: Reviewer 2  
 
Reviewer's report:  
 
PEER REVIEWER ASSESSMENTS:  
RELEVANCE - Does this case report make a contribution to medical knowledge, have 
educational value, or highlight the need for a change in clinical practice or diagnostic/prognostic 
approaches?  
Yes, this report contributes to medical knowledge  
 
CASE DESCRI PTION - Are the details of the case sufficiently well described to understand the 
patient's symptoms and course of treatment?  
No - there are minor issues  
 
DIAGNOSIS/INTERPRETATION - Based on the facts presented, are the diagnosis, 
interpretation, and cour se of treatment medically sound?  
Yes, the work described is medically sound  
 
DISCUSSION OF THE CASE - Does the discussion appropriately analyse the importance of the 
findings and their relevance to future understanding of disease processes, diagnosis or tr eatment? 
Has an adequate literature review pertinent to the case been included?  
No - there are minor issues  
 
OVERALL MANUSCRIPT POTENTIAL - Could an appropriately REVISED version of this 
work represent a technically sound contribution?  
Probably - with mino r revisions  
PEER REVIEWER COMMENTS:  
GENERAL COMMENTS: This report is about concomitant or coincidental occurrence of 
ganglionic TB, which maybe an unusual occurrence. Overall, the case is presented well. 
Considering that both cancer breast and TB have high mortality if left untreated, there is a 
message for practitioners in oncology/surgery to keep in mind the occurrence of TB among 
cancer patients either due to immunosuppression from cancer per se or from chemotherapy. To 
me this is the main message that the authors should emphasize.  
 
REQUE STED REVISIONS:  
The term discovered by patient during breast self examination and by doctors during follow up 
are inappropriate. Ganglionic TB and breast cancer both are not something known to us.  
Please specify "nearest health center" where an breast ul trasound and a mammogram. Was it a 
primary care or high medical centre? Please specify that TB case was notified and that DOTS 
was given.   Authors have discussed about previous case reports of similar nature/occurence. The 
authors need to compare and cont rast these reports to their report. What makes this case unique 
and how does it add to the literature?  Lastly, the authors should discuss more on the diagnostic 
challenges posed by concomitant occurrence of TWO different conditions. I advise that the 
authors also write that high index of suspicion for ganglionic TB during investigation of lymph 
nodes in breast cancer patients, more so in LMICs/developing countries which have a high 
burden of TB.  
 
ADDITIONAL REQUESTS/SUGGESTIONS:  
NONE  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
No 
 
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:  
 
Acceptable  
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  
manuscript, either now or in the future?  
 
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.  
 
This reviewer has been recruited by a partner organization, Research Square. Reviewers with 
declared or apparent competing interests are not utilized for these reviews. This reviewer has 
agreed to publication of their comments online under a Creative Commons Attribution License 
attributed to Research Square and was paid a small honorarium for completing the review within 
a specified timeframe. Honoraria for reviews such as this are paid regardless of the reviewer 
recommendation.  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is a ccepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecomm ons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal