Tuberculosis of the Male Breast Mimicking Breast Cancer. A Case Report from Low-Resource Country

Introduction: Tuberculosis (TB) mainly affects lungs but may also have extra-pulmonary localizations, among which the breast. The incidence of breast TB is estimated at 0.1% of all breast lesions in Western countries and 3-4% in tuberculosis endemic regions. Primary breast tuberculosis (PBT) is defined as tuberculosis localized only in the breast, in a patient with no history of pulmonary TB. PBT is very rare and represents 0.06%- 0.1% of all tuberculosis localizations. Case Report: We report here a case of a 22 years old male student presenting with a mildly painful right breast lump evolving for three months. Physical examination revealed a sub-areolar lump, 3 cm in diameter, ill-defined, fixed to the surrounding tissues and not warm to touch. Two axillary lymph nodes of less than 1 cm were palpable. The diagnosis of male breast cancer was suspected, with chronic abscess as differential diagnosis. Breast ultrasound revealed a mass of 32 mm in diameter with central necrosis. Needle biopsy of the breast lump confirmed the diagnosis of tuberculosis. The patient received oral anti-tuberculosis drugs for six months and the mass regressed completely without any complication. Conclusion: Breast tuberculosis is a rare entity especially in male breast, mimicking carcinoma. Clinical awareness is necessary during diagnostic workup to establish the correct diagnosis and treatment.