Breast Tuberculosis: Analysis of 24 Patients

Abstract

Introduction: Breast tuberculosis is a disease that is difficult to diagnose with its clinical appearance and can be confused with breast abscesses and breast carcinomas. In this study, we aimed to analyze 24 patients diagnosed with breast tuberculosis, followed up and treated. Material and Method: Among 4489 patients examined in the breast diseases outpatient clinic between January 2012 and December 2020, patients diagnosed with breast tuberculosis were evaluated retrospectively. Demographic, clinical features, radiological findings, histopathological and microbiological findings of the patients were recorded. Diagnosis, treatment protocols and treatment outcomes were evaluated. Results: A total of 24 breast tuberculosis cases were analyzed in the study. The mean age was 41.6 (28-64 years) and all patients were diagnosed for the first time. There was a history of oral contraceptive use in 10 patients. Among patients, 19 of them were in the reproductive age, and five patients were in the postmenopausal period. Four patients were in lactating period. On physical examination, breast mass was detected in 16 (67%) patients, abscess was present in 5 patients (20.8%), and sinus and discharge were evident in three patients (12.5%). Breast ultrasonography revealed a breast mass in 16 patients (67%), abscess in eight patients (33%), and axillary lymphadenopathy in six patients (25%). The diagnosis was made by core biopsy in 10 (41.6%) patients, fine-needle aspiration biopsy in three patients (12.5%), and incisional biopsy in 11 patients (45.8%). All patients were given quadruple antituberculosis therapy in the first 2 months for 9 months, and double antituberculosis therapy for 7 months. In addition to antituberculosis treatment, mass excision was performed in three patients (12.5%), segmental mastectomy in one patient (4.1%), simple mastectomy in one patient (4.1%), and abscess drainage were completed in eight patients (33.3%). Cure was achieved in all patients after treatment. Conclusion: Breast tuberculosis is a rare disease that can be difficult to diagnose unless the disease itself is suspected. As the diagnosis of the disease is delayed, the disease becomes complicated and the need for surgical treatment increases as well as medical treatment. Although there are different opinions about the duration of the treatment, in our study, cure was achieved with 9 months of treatment and no recurrence was observed in the 1-year follow-up. Since 10 patients had a history of oral contraceptive use, further research is needed to understand whether oral contraceptive use is a predisposing factor in the development of breast tuberculosis.