Tuberculosis of the breast: analysis of 17 cases

Abstract

Tuberculosis constitutes a major public health problem in the world. Certain extra-pulmonary locations of tuberculosis disease are very exceptional. Amongst these, tuberculosis of the breast is rare even in countries where this infection is endemic. This form of tuberculosis is characterized by clinical and radiological polymorphisms and might mimic other diseases, especially breast cancer. This retrospective study is entailing seventeen patients treated in the Onco-Gynecology Department of the Mohammed VI Cancer Treatment Center, in the Ibn Rochd University Hospital of Casablanca, for breast tuberculosis, over a period of three years. We report the epidemiological, clinical and paraclinical aspects and we specify the treatment and evolution of the patients.

Breast Tuberculosis: Case report and review literature

“…Studies support the idea that, in most cases, the constitutional symptoms of tuberculosis (fever, weight loss, night sweats, or general deterioration) are rarely seen in BTB (Bouziyane et al, 2020;Fatima & Naz, 2019;Khodabakhshi & Mehravar, 2014). There is a clear predilection of breast tuberculosis lesions for the outer quadrants, probably due to the proximity to the axillary region from which retrograde lymphatic spread (Gupta et al, 2017).…”

“…Breast tissue is highly resistant to mycobacteria. Since it provides a sterile atmosphere for the survival and proliferation of bacilli, such as spleen and skeletal muscle, through the two immune modalities, innate by the macrophage that phagocytoses the bacilli and cell-mediated T4 lymphocytes through the cytokines they produce (Bouziyane et al, 2020;Haitz et al, 2019). This resistance explains the difficulty of diagnosis and the rarity that Breast Tuberculosis (BTB) presents, commonly affecting young, multiparous and lactating women (Hammami et al, 2021;Fatima & Naz, 2019).…”

“…According to the World Health Organization (WHO), in 2014, 9.6 million new cases of TB were registered, of which 1.1 million were HIV-positive patients (Shrestha et al, 2019;Bouziyane et al, 2020). In the same year, 1.5 million deaths were recorded due to complications from this disease.…”

“…The breast is a rare site of manifestation of extrapulmonary tuberculosis, especially as a primary manifestation, even in tuberculosis endemic countries (Sinha & Rahul, 2019;Bouziyane et al, 2020). Breast tuberculosis was first described by Sir Astley Cooper in 1829 as "scrofulous swelling in the breast of young women" and since then numerous important studies have emerged and everyone is unanimous about its rarity.…”

A Retrospective Analysis of the Clinicopathological Features of Patients with Tuberculous Mastitis: A Single Institution’s Experience

“…The highest incidence of TBm occurs in developing countries, such as India, where the reported incidence of TBm varies between 0.64% and 3.59% of patients with TB [3, 11]. Conversely, the incidence of TBm in first-world countries is lower and only represents 0.1% of breast lesions examined histologically [12]. A literature review found no studies have documented the histopathological findings in the context of HIV co-infection in Sub-Saharan Africa, hence the rationale for this study.…”