Breast tuberculosis: a diagnosis not to be forgotten

Area of Science:

• Infectious Diseases
• Oncology
• Radiology

Background:

• Breast tuberculosis (TB) is a rare extrapulmonary manifestation of Mycobacterium tuberculosis.
• It often mimics benign or malignant breast lesions, posing diagnostic challenges.

Purpose of the Study:

• To elucidate the clinical, imaging, and treatment characteristics of breast TB.
• To enhance diagnostic and therapeutic strategies for this uncommon condition.

Main Methods:

• A retrospective analysis of patients diagnosed with breast TB between 1997 and 2018.
• Inclusion criteria: hospitalization in the infectious diseases department for breast TB.

Main Results:

• Twenty-two women (mean age 39 years) were studied; 81.8% were multiparous.
• Common symptoms included lump and mastalgia (86.3%), with axillary lymphadenopathy in 63.6%.
• Ultrasound revealed mass lesions (77.2%) and fistulous tracts (31.8%); mammography showed asymmetric density (89.5%). Diagnosis confirmed by granulomas/necrosis in 59.1%.

Conclusions:

• Breast TB is a crucial differential diagnosis for breast lumps with lymphadenopathy, particularly in endemic areas.
• Excision biopsy for histological/bacteriological confirmation is typically required.
• Antitubercular therapy yielded favorable outcomes in 91% of cases, with a 9% relapse rate.