Profile of patients with tuberculous mastitis in a UK district general hospital

Le résumé fourni par la source

Introduction: Tuberculous mastitis (TM) is a rare extrapulmonary manifestation of TB which is gaining popularity in Europe and America due to increased immigration from endemic countries. Aim: To assess the clinical profile of patients with presumed TM seen at the TB clinics of SWBH NHS Trust UK. Methods: A retrospective review of the case records of 13 consecutive adult patients with histological confirmation of granulomatous breast disease referred to the TB clinics between May 2016 and May 2021 based on clinical and laboratory suspicion of TM. Results: 61.5% of the patients referred for TB treatment had necrotising granulomatous disease. Majority were of southern Asian ethnicity (84.6%) and aged 21– 40 years. Nine patients (69.2%) presented with a breast lump, while the rest had isolated axillary lymphadenopathy. None had respiratory symptoms on initial evaluation. Four patients (30.8%) had previous TB contact and one patient (7.7%) had prior treatment for latent TB. None of the patients had bilateral breast disease. Microscopy for acid fast bacilli was positive in one patient (11.1%) and only 28.6% of the samples sent for TB culture returned positive. All patients who were screened for HIV infection had negative results. Eight patients had chest CT scan, five of whom had at least one abnormal finding with the commonest being intrathoracic lymph nodes. 75% of the patients who had TB chemotherapy made complete clinical recovery. Conclusion: TM should be suspected in young and middle-aged individuals from TB-endemic countries with breast disease and those with previous TB contact. Collaboration between breast surgeons and chest physicians is encouraged to guide appropriate investigation of patients.

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