[Primary tuberculosis of the breast]

Despite generalized BCG vaccination, tuberculosis remains a public health issue in France. Breast localizations are exceptional and constitute a diagnostic and therapeutic challenge.

A 34-year-old woman who was nursing her 3-month old infant underwent emergency surgery for a breast abscess that had been incised one month earlier and treated with non-specific antibiotic therapy without success. All necrotic tissue was removed. Pathology provided the diagnosis of tuberculosis. An anti-tuberculosis regimen (INH + rifampicin + PZA + ethambutol for two months followed by INH + rifampicin for 7 months) was instituted. The epidemiology search was negative and no extension was found. The clinical course was favorable at 6 months.

Tuberculosis is rarely localized in the breast. The main differential diagnosis is breast cancer. Pathology examination is required for diagnosis. Anti-tuberculosis antibiotic therapy may be associated with surgery in case of extension.