CRA23 TUBERCULOSIS OF THE BREAST: A RARE EXTRAPULMONARY MANIFESTATION

Khairun Nabihah Nordin, Muhamad Hadie Aiman Asli, Shaharudin Abdullah
Hospital Sultan Zainal Abidin, Gong Badak, Terengganu

Introduction
Primary breast tuberculosis is a rare cause of breast mass, affecting mainly lactating and multiparous females. It is often confused with breast carcinoma, granulomatous mastitis or pyogenic abscess.

Objectives
A case report of primary breast tuberculosis in a 43 years old female.

Results
A 43 years old female presented with a painful breast lump for 1 week. Ultrasound of the breast revealed  upper outer hypoechoic irregular solid lesion with minimal vascularity. The lesion scored BiRADS 4a on mammogram. Initial histopathological examination showed granulomatous mastitis surrounded by lymphoplasmacytic inflammatory cell infiltrates with central necrosis. Initially she was started on prednisolone. However later the sample tested positive for Ziehl-Neelson. She was started on oral intensive phase antituberculosis and currently is still undergoing treatment.

Conclusions
Breast tuberculosis is a rare cause of breast mass. Breast tissue is usually resistant to tuberculosis bacillus [1]. Primary form of breast tuberculosis can occur due to abrasion in the skin or nipple crack. Symptoms vary from lump, mastalgia, breast discharge and skin ulceration. Risk factors include lactating and multiparous women. It is difficult to distinguish breast tuberculosis from other more common breast mass like granulomatous mastitis or breast malignancy[2]. High clinical index of suspicion, imaging and biopsies are mandatory to confirm the diagnosis. The mainstay treatment is antitubercular therapy. Surgical intervention may be needed if there is lack of response to antitubercular therapy [3].

References :

  1. Hammami, Kouba. Breast tuberculosis : diagnosis not to be forgotten. J Turk Ger Gynecol Assoc 2021; 22: 107-11.
  2. Tuna et al. Breast tuberculosis: analysis of 24 patients. J Health Sci Med 2022; 5(1): 88-93.
  3. Baykan et al. Insights Imaging. Turkey. 2021