Tuberculosis of the breast: rare but still extant

Author(s): Hale JA, Peters GN, Cheek JH

Abstract

Tuberculosisofthebreastisararemaladythatisusuallymanifestedbyaunilateralmasssuggestiveofcarcinomaorsometimesofabscess.Mammographyalsosuggestscarcinomainmostinstances.However,atoperation,thediscoveryofnecrotictissueorabscessmayleadtothesuspicionofinfectiousorinflammatorydiseaseratherthanneoplasm.Thediagnosisoftuberculosismaybeestablishedbythedemonstrationofacid-fastbacilliinexcisedtissue,byculturestudies,orbyguineapiginoculation;however,thediagnosisisusuallynotsuspected.Inthepast,mastectomywastheusualtreatment.Today,successfultreatmentcombinesantituberculousdrugtherapywiththeremovalofinfectedbreasttissue.Theprognosisforcompletecureisexcellent.Onecaseofsecondarytuberculousmastitishasbeenreportedherein.Thepatient,anEgyptianwomanresidingintheUnitedStatessince1973,wastreatedinEgyptforpulmonarytuberculosisatage17.Shepresentedin1982withabreastmassthatmimickedcarcinomaonphysicalexaminationandmammograms,butexcisionalbiopsyandhistologicexaminationrevealedabreastabscessthatcontainedcaseousmaterialandasolitaryacid-fastbacillus.Thepatientwascuredofherdiseaseafterappropriateoperationandacourseofantituberculousdrugs.Thishasbeentheonlydocumentedcaseofmammarytuberculosisatourinstitution.Despiteitsrarity,tuberculosisofthebreastshouldnotbeforgotteninthisageofworldtravel.

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