BREAST TUBERCULOSIS: A RARE OCCURRENCE WITH DIAGNOSTIC CHALLENGE IN A 21st CENTURY NIGERIAN FEMALE

Tuberculosis of the breast, also referred to as tuberculous mastitis, represents an extremely rare presentation of tuberculosis. It constitutes < 0.1 % of all breast pathology and <2 % of all tuberculous cases. It’s an infrequent manifestation of extra-pulmonary tuberculosis. It is characterized by diagnostic challenges with majority of preliminary clinical diagnosis being breast carcinoma or pyogenic breast abscess. The diagnosis is challenging due to the non-specific clinical and radiological findings, in addition to insufficient specimen with often negative microscopy and culture results. We report the case of tuberculosis of the right breast in a young multiparous woman, a healthcare worker who presented with clinical features suspected to be breast tuberculosis in whom diagnosis was made based on clinical, hematological parameters and positive mantoux test only. She was commenced on empirical Anti-tuberculous medications with excellent clinical response after 6 months of therapy. This report highlights the importance of considering tuberculosis as a differential diagnosis in women with breast lumps and sinuses. In addition, this report demonstrates the diagnostic challenges in patients with breast tuberculosis and how empirical therapy following few simple investigations could yield the desired result. Keywords: Anti-tuberculous medication, Breast tuberculosis, Carcinoma, Extra-pulmonary