1647. Breast Tuberculosis: A Diagnostic Challenge

Abstract Background Breast tuberculosis is a rare disease accounting for less than 0.1% in developed countries and 3-4% in high incidence regions. Its diagnosis remains challenging as it closely mimics breast cancer and abscess. We aimed to study the epidemiological, clinical and therapeutic features of breast tuberculosis. Methods We conducted a retrospective study including all patients hospitalized in the infectious diseases department for breast tuberculosis between 2000 and 2018. Results We enrolled 17 women with a mean age of 40 ±12 years. Nine patients came from rural area (52.9%). Two patients (11.7%) had a history of tuberculosis. None of our patients had a family history of tuberculosis, nor breast cancer. The duration of symptoms varied from one month to a year. At the time of diagnosis, three patients were pregnant (17.6%) and one patient (5.8%) was lactating. The most common clinical symptoms were mastalgia (88.2%), palpable breast lump (88.2%) and fever (76.5%). The average size of the breast lump was 5 ±2 cm. Eight patients (47%) had associated signs of inflammation, 11 patients had axillary lymphadenopathy (64.7%) and four patients had nipple discharge (23.5%). The diagnosis was confirmed by histopathological proof in 14 cases (82.4%) and bacteriological proof in three cases (17.6%). The tuberculin skin test was positive in 10 cases (58.8%). The mean duration of antitubercular therapy was 10 ±1 months. Excision of the mass were indicated in 10 cases (58.8%) and a mastectomy in 2 cases (11.7%). Two cases of relapse were noted (11.7%). Conclusion Breast tuberculosis should be suspected in front of breast abscess or inflammation with poor response to antibiotic treatment, especially in patients from endemic countries. Disclosures All Authors: No reported disclosures