TUBERCULOSIS OF THE BREAST - A REPORT OF 2 CASES

Tuberculosis of the breast is an infrequent condition accounting for 0 .6 % to 4.5 % of all breast diseases. Two cases are reported. Patients were aged 33 and 20 years, respectively, and both presented with an i nflammatory lump in the left breast. In the first patient, cancer was initially considered, whereas in the second a history of tuberculosis and concomitant left pleural effusion immediately pointed to tuberculo sis. In both cases, the diagnosis was established by examination of su rgical biopsy specimens. A review of the literature found 213 cases, o f which 30 % were primary. Nodular disease was the most common form. D iagnosis was established by histological studies ; in 28.4 % of cases, the tubercle bacillus was recovered in biopsy specimens, fine-needle aspirates, or sputum samples. The main differential diagnoses were bre ast cancer and other breast diseases ; some cases with several concomi tant diseases were reported. Management relied mainly on antituberculo us agents. Surgery was used in advanced destructive disease to remove the bulk of diseased tissue or to ensure radical resection especially in patients with concomitant cancer. Outcome was favorable in most cas es. Recurrent disease was seen in 3.2 % of patients. Treatment failed in one patient who was unable to tolerate antituberculous agents.