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Breast Tuberculosis in Women: A Systematic Review
Gianluca Quaglio
Gianluca Quaglio
European Parliamentary Research Services (EPRS), European Parliament, Brussels, Belgium;
Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy;
Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, University of Maastricht, Maastricht, The Netherlands;
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Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy;
Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences, University of Maastricht, Maastricht, The Netherlands;
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Damiano Pizzol
Damiano Pizzol
Operational Research Unit, Doctors with Africa CUAMM, Beira, Mozambique;
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Petros Isaakidis
Petros Isaakidis
Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa;
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Arianna Bortolani
Arianna Bortolani
Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy;
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Francesca Tognon
Francesca Tognon
Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy;
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Claudia Marotta
Claudia Marotta
Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy;
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Francesco Di Gennaro
Francesco Di Gennaro
Department of Infectious Diseases, University of Bari, Bari, Italy;
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Giovanni Putoto
Giovanni Putoto
Operational Research Unit, Doctors with Africa, Collegio Universitario Aspiranti e Medici Missionari (CUAMM), Padua, Italy;
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Piero L. Olliaro
Piero L. Olliaro
Special Programme for Research and Training in Tropical Diseases, World Health Organization (WHO/TDR), Geneva, Switzerland;
Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
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Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
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Breast tuberculosis (TB) is rarely reported and poorly described. This review aims to update the existing literature on risk factors, clinical presentations, constitutional symptoms, diagnostic procedures, and medical and surgical treatments for breast TB. In all, 1,478 cases of breast TB were collected. Previous history of TB was reported in 19% of cases. The most common clinical appearance of the lesion was breast lump (75%). The most common associated finding was axillary lymphadenitis (33%) followed by sinus or fistula (24%). The most common symptoms were pain and fever, reported in 42% and 28% of cases, respectively. The most used diagnostic method was fine-needle aspiration cytology (32%), followed by biopsy (27%), acid-fast bacteria Ziehl–Neelsen stain (26%), culture (13%), and polymerase chain reaction (2%). These tested positive in 64%, 93%, 27%, 26%, and 58% of cases, respectively. The majority (69%) of patients received a 6-month anti-TB treatment (isoniazid, rifampicin, pyrazinamide, and ethambutol). Surgery consisted of excision in 39% of cases, drainage in 23%, and mastectomy in 5%. The great majority of patients had a positive outcome. It often mimics breast cancer, which makes it difficult to diagnose. Most patients, when diagnosed in time, respond to antitubercular therapy alone.
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Author Notes
Disclaimer: The views expressed in this publication are the sole responsibility of the authors and do not necessarily reflect the views of the affiliated organizations.
Authors’ addresses: Gianluca Quaglio, European Parliamentary Research Services, European Parliament, Brussels, Belgium, E-mail: gianluca.quaglio@europarl.europa.eu. Damiano Pizzol, Operational Research Unit, Doctors with Africa CUAMM, Beira, Mozambique, E-mail: d.pizzol@cuamm.org. Petros Isaakidis, Médecins Sans Frontières, Southern Africa Medical Unit (SAMU), Cape Town, South Africa, E-mail: petros.isaakidis@joburg.msf.org. Arianna Bortolani, Francesca Tognon, Claudia Marotta, and Giovanni Putoto, Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy, E-mails: a.bortolami@cuamm.org, f.tognon@cuamm.org, marotta.claudia@gmail.com, and g.putoto@cuamm.org. Francesco Di Gennaro, Department of Infectious Diseases, University of Bari, Bari, Italy, E-mail: cicciodigennaro@yahoo.it. Piero Luigi Olliaro, Special Programme for Research and Training in Tropical Diseases, World Health Organization (WHO/TDR), Geneva, Switzerland, E-mail: olliarop@who.int.
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