International Journal of Clinical Case Reports 2017, Vol.7, No.19, 86-90
89
In our observation, in front of an inflammatory breast in an elderly and menopausal woman, the first diagnosis to
evoke is essentially breast cancer and only the histological examination which allowed making the diagnosis of
mammary tuberculosis.
Therapeutic management of breast tuberculosis is usually based on conventional quadruple therapy with isoniazid,
rifampicin, ethambutol and pyrazinamide for two months, followed by isoniazid and rifampicin for a total
duration of nine to twelve months.
The surgical act is primarily a means of diagnosis by performing biopsies, excisions or lumpectomies to obtain
histological certainty (Elmrabet et al., 2002; Ben et al., 2005; Luh et al., 2007). In the case of resistance to
treatment antituberculosis or locally advanced diseases, a mastectomy can be offered for therapeutic purposes
(Romero et al., 2000; Elmrabet et al., 2002; Ben et al., 2005; Harris et al., 2006; Luh et al., 2007). Currently, some
authors advocate percutaneous drainage of abscess under tomographic or ultrasound control.
Once the treatment is done, the prognosis is excellent, subject to appropriate care of others tuberculous
localizations (Jalali et al., 2005). However, rigorous monitoring of adherence to treatment is necessary to prevent
recurrence and the development of resistance to anti-tuberculosis drugs. Finally, the risk of contamination of the
breastfeeding child deserves special attention, and can be discussed weaning.
3 Conclusions
Breast tuberculosis is a very rare localization of the tuberculosis. In tuberculosis endemic countries, this diagnosis
should not be ignored and should be mentioned in the light of certain clinical and radiological data.
Breast cancer remains the main differential diagnosis to be eliminated. The medical and surgical management
allows a favorable evolution in the majority of the cases.
Authors’ contributions
R.H: Editing and supervision,read and approved the final manuscript. D.A: participated in the drafting of the observation, read and
approved the final manuscript. B.N: participated in the drafting of the discussion, read and approved the final manuscript. A.A:
checking references. All authors read and approved the final manuscript.
Acknowledgments
We thank the anatomopathology department of Ibn El Jazzar Hospital, Kairouan.
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