1647 - Breast Tuberculosis: A Diagnostic Challenge

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Presenting Author(s)

FH

Fatma Hammami

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

MK

Makram Koubaa

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AC

Amal Chakroun

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KR

Khaoula Rekik

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
FS

Fatma Smaoui

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
EE

Emna Elleuch

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CM

Chakib Marrakchi

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MB

Mounir Ben Jemaa

MD
Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
Sfax, Sfax, Tunisia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Breast tuberculosis is a rare disease accounting for less than 0.1% in developed countries and 3-4% in high incidence regions. Its diagnosis remains challenging as it closely mimics breast cancer and abscess. We aimed to study the epidemiological, clinical and therapeutic features of breast tuberculosis.

Methods: We conducted a retrospective study including all patients hospitalized in the infectious diseases department for breast tuberculosis between 2000 and 2018.

Results: We enrolled 17 women with a mean age of 40 ±12 years. Nine patients came from rural area (52.9%). Two patients (11.7%) had a history of tuberculosis. None of our patients had a family history of tuberculosis, nor breast cancer. The duration of symptoms varied from one month to a year. At the time of diagnosis, three patients were pregnant (17.6%) and one patient (5.8%) was lactating. The most common clinical symptoms were mastalgia (88.2%), palpable breast lump (88.2%) and fever (76.5%). The average size of the breast lump was 5 ±2 cm. Eight patients (47%) had associated signs of inflammation, 11 patients had axillary lymphadenopathy (64.7%) and four patients had nipple discharge (23.5%). The diagnosis was confirmed by histopathological proof in 14 cases (82.4%) and bacteriological proof in three cases (17.6%). The tuberculin skin test was positive in 10 cases (58.8%). The mean duration of antitubercular therapy was 10 ±1 months. Excision of the mass were indicated in 10 cases (58.8%) and a mastectomy in 2 cases (11.7%). Two cases of relapse were noted (11.7%).

Conclusion:

Breast tuberculosis should be suspected in front of breast abscess or inflammation with poor response to antibiotic treatment, especially in patients from endemic countries.