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Babamahmoodi F, Babamahmoodi A, Barzegar R, Sadr M, Rezaei M, Marjani M. Breast Tuberculosis in Iran: A Comprehensive Review. Int J Mycobacteriol 2024; 13:1-6. [PMID: 38771272 DOI: 10.4103/ijmy.ijmy_32_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/27/2024] [Indexed: 05/22/2024] Open
Abstract
ABSTRACT Tuberculosis (TB) remains a significant global health concern and kills millions of people every year. While TB can affect any organ in the body, breast TB is relatively uncommon. This study presents a comprehensive review of literature spanning 23 years, with a focus on cases of breast TB in Iran. Among the 96 cases found, the majority (89.6%) fell within the age range of 20-60, with a striking prevalence among women (98.9%). Common symptoms included pain and palpable mass, each presenting in approximately 60.4% of cases. Notably, only a quarter of patients had a confirmed history of exposure to a known TB case. Left breast involvement was more prevalent (58.3%), with ipsilateral lymph node enlargement observed in 40.6% of cases. Given the clinical presentation of breast TB, which often leads to misdiagnosis, a significant proportion of cases (68.7%) were diagnosed through excisional biopsy. Following a standard 6-month regimen of anti-TB drugs, relapse occurred in only 4.2% of cases. This study highlights the need for heightened awareness and vigilance in diagnosing breast TB, especially in regions with a high burden. Although breast TB poses diagnostic challenges, with prompt identification and treatment, the prognosis is generally favorable, with a low incidence of relapse.
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Affiliation(s)
- Farhang Babamahmoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolreza Babamahmoodi
- Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rahim Barzegar
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Makan Sadr
- Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Rezaei
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Marjani
- Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Duan W, Xiao S, Yang J, Su X, Kang Z, Wang A. Letter to the Editor: Breast Tuberculosis Is Mimicking Breast Tumor. Surg Infect (Larchmt) 2023; 24:757-758. [PMID: 37195703 DOI: 10.1089/sur.2023.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Affiliation(s)
- Wentao Duan
- Department of General Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Senlin Xiao
- Department of General Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Jialin Yang
- Department of General Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Xiangjie Su
- Department of General Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Zhou Kang
- Department of General Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Ankang Wang
- Department of General Surgery, Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
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Hoang H, El-Helou E, Pop CF, Shall A, Zaiter M, Naccour J, Nguyen TTH, Ho XD, Nguyen VC. Primary Breast Tuberculosis Mastitis Manifested as Nonhealing Abscess. Surg J (N Y) 2022; 8:e123-e126. [PMID: 35712051 PMCID: PMC9197598 DOI: 10.1055/s-0042-1749123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
Primary breast tuberculosis (TB) is a rare extrapulmonary TB mainly affecting young women of childbearing age from endemic countries. Its incidence is increasing in immunocompromised and HIV-infected people and with the emergence of drug-resistant strains of
Mycobacterium tuberculosis
(MTB). There are no specific clinical signs suggestive of this disease, it often presents as a hard mass or breast abscess. There is an overlap of features with other inflammatory, infectious, benign lesions, fat necrosis and malignant neoplasms of the breast. The detection of MTB remains the gold standard for diagnosis. Several other diagnostic modalities are used, with varying lack of sensitivity and specificity, and with a range of false negatives. A quarter of cases were treated solely on the basis of clinical, imaging or histological suspicion, without confirmation of the diagnosis. Therefore, we report the case of a young Vietnamese woman, presented for a nonhealing breast abscess, and diagnosed with breast TB based on the patient's ethnicity, histological findings, lack of clinical response to conventional antibiotic therapy, and a good clinical response to anti-TB treatment.
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Affiliation(s)
- Huu Hoang
- Department of Oncology, Hue college of Medicine and Pharmacy—Hue University, Hue, Vietnam
| | - Etienne El-Helou
- Department of Surgical Oncology, Institute Jules Bordet, Brussels, Belgium
| | - Catalin-Florin Pop
- Department of Surgical Oncology, Institute Jules Bordet, Brussels, Belgium
| | - Ammar Shall
- Department of Surgical Oncology, Institute Jules Bordet, Brussels, Belgium
| | - Manar Zaiter
- Department of Radiology, Institute Jules Bordet, Brussels, Belgium
| | - Jessica Naccour
- Department of Emergency Medicine, Hopital Erasme, Brussels, Belgium
| | - Tran T. H. Nguyen
- Department of Oncology, Hue college of Medicine and Pharmacy—Hue University, Hue, Vietnam
| | - Xuan D. Ho
- Department of Oncology, Hue college of Medicine and Pharmacy—Hue University, Hue, Vietnam
| | - Van C. Nguyen
- Department of Oncology, Hue college of Medicine and Pharmacy—Hue University, Hue, Vietnam
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TUNA T, COŞKUN S. Breast tuberculosis: analysis of 24 patients. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1005328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
The presentation of tuberculosis can be nonspecific and atypical in patients with human immunodeficiency virus infection, especially in the extrapulmonary forms. The incidence of breast tuberculosis is very low. We report a case of primary breast tuberculosis: a 26-year-old woman with a 5-month history of a left-sided breast lump associated with pain. Biopsy of the breast lump for histological examination suggested granulomatous inflammation, secretions tested with GeneXpert for Mycobacterium tuberculosis were positive, and no evidence of tuberculosis was found in other organs. She was treated with incision, drainage, dressing, and 6 months of anti-tuberculosis treatment; her prognosis was good.
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Affiliation(s)
- Ke Xiao
- Department of Infectious Diseases, the Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Li Zhong
- Department of Infectious Diseases, the Affiliated Hospital of Southwest Medical University, Sichuan, China
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Sprenger F, Vicente Filho V, Kluppel ST, Salvador GLDO, Louveira MH. Breast myiasis: Are we prepared for the correct diagnosis? Breast J 2021; 27:675-677. [PMID: 33982346 DOI: 10.1111/tbj.14239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/28/2022]
Abstract
Cutaneous myiasis is an endemic infestation in Latin America and Africa. Many unusual sites of larval infection can cause diagnostic confusion, especially if the patient is not from an endemic area. In the breast, the furuncular aspect suggests some differential diagnosis. We report a case of an 84-year-old patient with an ulcerated lesion on the right breast, who was referred to the reference service to exclude malignancy. Considering the clinical aspects and after further evaluation with imaging methods, she was diagnosed with myiasis. This study reinforces the importance of differential diagnosis of myiasis in patients that come from endemic areas.
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Affiliation(s)
- Flávia Sprenger
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | | | - Maria Helena Louveira
- Department of Radiology, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
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Hammami F, Koubaa M, Hentati Y, Chakroun A, Rekik K, Marrakchi C, Mnif Z, Smaoui F, Jemaa MB. Breast tuberculosis: a diagnosis not to be forgotten. J Turk Ger Gynecol Assoc 2021; 22:107-111. [PMID: 33631876 PMCID: PMC8187975 DOI: 10.4274/jtgga.galenos.2021.2020.0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: To study the clinical characteristics and imaging features of breast tuberculosis (TB) and to describe treatment. Material and Methods: A retrospective study including all patients hospitalized in the infectious diseases department for breast TB between 1997 and 2018. Results: Twenty-two women, with a mean age of 39±12 years, were identified. In total, 18 patients were multiparous (81.8%). Both lump and mastalgia were the presenting symptoms in 19 cases (86.3%). Ipsilateral axillary lymphadenopathy was noted in 14 cases (63.6%). The most common finding on ultrasound was a well or poorly defined mass lesion, noted in 17 cases (77.2%), followed by fistulous tracts in seven cases (31.8%). Mammography showed focal, asymmetric breast density in 17 cases (89.5%) and diffuse in two cases (10.5%). The diagnosis was confirmed based on the presence of epithelioid cell granulomas and caseous necrosis in 13 cases (59.1%). Patients received antitubercular therapy for a mean duration of 11±5 months. The disease evolution was favorable in 20 cases (91%). There were two relapsing cases (9%). Conclusion: Breast TB should be considered in the differential diagnosis of young patients presenting with palpable lump with axillary lymphadenopathy, especially in endemic regions. The diagnosis confirmation usually requires an excision biopsy providing histological or bacteriological evidence.
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Affiliation(s)
- Fatma Hammami
- Department of Infectious Diseases, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia,Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Makram Koubaa
- Department of Infectious Diseases, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia,Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Yosr Hentati
- Department of Radiology, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Amal Chakroun
- Department of Infectious Diseases, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia,Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Khaoula Rekik
- Department of Infectious Diseases, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia,Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Chakib Marrakchi
- Department of Infectious Diseases, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia,Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Zeineb Mnif
- Department of Radiology, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Fatma Smaoui
- Department of Infectious Diseases, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia,Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mounir Ben Jemaa
- Department of Infectious Diseases, University of Sfax, Hedi Chaker University Hospital, Sfax, Tunisia,Extra-pulmonary Research Unity UR17SP12, Hedi Chaker University Hospital, Sfax, Tunisia
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