Breast tuberculosis: a case series

Authors

  • Mounir Moukit Department of Gynecology, Military Hospital of Meknes, Meknes, Morocco
  • Youssef Bougrini Department of Pneumology, Military Hospital Moulay Ismail, Meknes, Morocco
  • Mohammed Rahmoune Department of Gynecology, Military Hospital of Meknes, Meknes, Morocco
  • Ismail Allilou Department of Gynecology, Military Hospital of Meknes, Meknes, Morocco
  • Abdellah Babahabib Department of Gynecology, Military Hospital of Meknes, Meknes, Morocco

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240805

Keywords:

Breast, Koch's Bacillus, Granuloma, Caseous necrosis, Antitubercular agents

Abstract

Tuberculosis is one of the leading infectious and contagious diseases, caused by bacteria belonging to the Mycobacterium family. Breast involvement ranks last among the extrapulmonary manifestations of tuberculosis but remains an important clinical condition that may present clinical and radiological similarities with breast cancer, thus requiring a thorough diagnostic approach including histological and/or bacteriological confirmation. This is a retrospective study conducted at the department of Gynecology and Obstetrics of the Military Hospital Moulay Ismail - Meknes, over a period of 4 years. A total of 6 cases of breast tuberculosis were observed, resulting in an incidence rate of 6 cases per 7600 women-years. The mean age of patients was 39 years. Signs of tuberculosis impregnation were found in 33% of cases. The clinical forms encountered, in descending order of frequency, were: diffuse form (50% of cases), nodular form (33% of cases), and sclerotic form (16% of cases). The radiological findings were almost always suggestive of a suspicious lesion. Diagnosis was primarily based on the histopathological study of breast biopsy. All our patients received a standard regimen of anti-tubercular treatment including: 4 months of Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol followed by 2 months of Rifampicin and Isoniazid with favorable outcomes. Only one patient experienced a recurrence due to under dosing of Rifampicin, which was managed with a total of 9 months of treatment. One patient underwent additional surgical drainage. Early and thorough diagnosis of breast tuberculosis is crucial as it helps avoid mutilating surgery in often young women.

References

World Health Organization. Global Tuberculosis Report 2020. 2020. Available at: https://www. who.int/publications-detail-redirect/ 9789240013131. Accessed on 17 January 2024.

Thompson KS, Donzelli J, Jensen J, Pachucki C, Eng AM, Reyes CV. Breast and cutaneous mycobacteriosis: Diagnosis by fine-needle aspiration biopsy. Diagn Cytopathol. 1997;17:45-9.

Hawilo A, Abdelmalek R, Mebazaa A, Addouni O, Kanoun F, El Euch D, et al. Tuberculosis of the breast: a rare often unrecognized diagnosis. Médecine Santé Trop. 2012;22:292-6.

Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009;9:737-46.

Amadou MLH, Abdoulaye O, Amadou O, Biraïma A, Kadri S, Amoussa AAK, et al. Profil épidémiologique, clinique et évolutif des patients tuberculeux au Centre Hospitalier Régional (CHR) de Maradi, République du Niger. Pan Afr Med J. 2019;33:120.

Chahboune M, Barkaoui M, Iderdar Y, Alwachami N, Mourajid Y, Ifleh M, et al. Profil épidémiologique, aspects diagnostiques et évolutifs des patients tuberculeux au centre de diagnostic de la tuberculose et des maladies respiratoires de Settat, Maroc. Pan Afr Med J. 2022;42:185.

Ministère de la Santé. Epidemiological Bulletin. 2020. 2021. Available at: https://www.sante.gov.ma/ Publications/Pages/Bullten_%C3%89pid%C3%A9miologique.aspx. Accessed on 17 January 2024.

Cooper A. Illustrations of the Diseases of the Breast. London: Longman, Rees, Orme, Brown, and Green. Wellcome Collection. 1829.

Ducroz B, Nael LM, Gautier G, Monréal JM, Marquet M, Cloup N. Bilateral breast tuberculosis: a case report. Review of the literature. J Gynecol Obstet Biol Reprod. 1992;21:484-8.

Gilbert AI, McGough EC, Farrell JJ. Tuberculosis of the breast. Am J Surg. 1962;103:424-7.

Marinopoulos S, Lourantou D, Gatzionis T, Dimitrakakis C, Papaspyrou I, Antsaklis A. Breast tuberculosis: Diagnosis, management and treatment. Int J Surg Case Rep. 2012;3:548-50.

Khaiz D, Lakhloufi A, Chehab F, Abi F, Bouzidi A. Tuberculose mammaire : à propos de deux cas. J Maroc Sci Médicales. 1993;69:454-8.

Thimmappa D, Mallikarjuna MN, Vijayakumar A. Breast Tuberculosis. Indian J Surg. 2015;77:1378-84.

Wilson JP, Chapman SW. Tuberculous mastitis. Chest. 1990;98:1505-9.

Zekri H, Boufettal H, Bennani O, Laghzaoui M, Bouhya S. La Tuberculose Mammaire À Propos De 10 Cas. J Maroc Sci Médicales. 2010;17.

Kachewar S. Primary tubercular mastopathy. Australas Med J. 2012;5:436-9.

Gueye M, Badiane A, Diallo M, Lakh NA, Mbodji A, Kane-Gueye SM, et al. Multivisceral tuberculosis mimicking a metastatic breast cancer. Health Sci Dis. 2020;21:120-2.

Bouhout T, Serji B, Egyir EU, amri BE, Bouhout I, Soufi M, et al. Tuberculose mammaire: à propos d’un cas. Pan Afr Med J. 2017;28:183.

Quaglio G, Pizzol D, Isaakidis P, Bortolani A, Tognon F, Marotta C, et al. Breast Tuberculosis in Women: A Systematic Review. Am J Trop Med Hyg. 2019;101:12-21.

Darré T, Tchaou M, N’Timon B, Patassi AA, Aboubakari A, Sonhaye L, et al. Tuberculosis of the Breast in Togo: A Series of 28 Presumed Cases. Bull Société Pathol Exot. 2017;110:238-41.

Ben Hassouna J, Gamoudi A, Bouzaiene H, Dhiab T, Khomsi F, Chargui R, et al. Tuberculose mammaire : étude rétrospective de 65 cas. Gynécologie Obstétrique Fertil. 2005;33:870-6.

Gupta D, Rajwanshi A, Gupta SK, Nijhawan R, Saran RK, Singh R. Fine Needle Aspiration Cytology in the Diagnosis of Tuberculous Mastitis. Acta Cytol. 2011;43:191-4.

Salem A, Bennaceur R, Driss M, Mehiri S, Mrad K, Rajhi H, et al. Imagerie des mastites granulomateuses idiopathiques. Imagerie de la Femme. 2008;18:46-54.

Daali M, Hssaida R, Hda A. La tuberculose primitive du sein. Presse Med. 2001;30:431-3.

Al-Marri MR, Almosleh A, Almoslmani Y. Primary tuberculosis of the breast in Qatar: ten year experience and review of the literature. Eur J Surg Acta Chir. 2000;166:687-90.

Kakkar S, Kapila K, Singh MK, Verma K. Tuberculosis of the breast. A cytomorphologic study. Acta Cytol. 2000;44:292-6.

Zandrino F, Monetti F, Gandolfo N. Primary tuberculosis of the breast. A case report. Acta Radiol. 2000;41:61-3.

Benbrahim H, Loussaief C, Hadded A, Toumi A. La mastite tuberculeuse: étude de 15 cas. Rev Tun Infectiol. 2008;2:31-4.

Khanna R, Prasanna GV, Gupta P, Kumar M, Khanna S, Khanna AK. Mammary tuberculosis: report on 52 cases. Post grad Med J. 2002;78:422-4.

Da Silva BB, Lopes-Costa PV, Pires CG, Pereira-Filho JD, Dos Santos AR. Tuberculosis of the breast: analysis of 20 cases and a literature review. Trans R Soc Trop Med Hyg. 2009;103:559-63.

Mecherfi AK, Berrabah Y. La tuberculose mammaire à propos de 8 cas. Revue Des Maladies Respiratoires. 2019;36:162-3.

Kumar P, Sharma N. Primary MDR-TB of the breast. Indian J Chest Dis Allied Sci. 2003;45:63-5.

Elmrabet F, Ferhati D, Amenssag L, Kharbach A, Chaoui A. Tuberculose Mammaire. Med Trop. 2002;62:77-80.

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Published

2024-03-28

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Section

Case Series