Breast is a rare location for Mycobacterium tuberculosis (MbT) infection. The paper analyses the first registered case with MBT location in a young Romanian women: a chronic primary TB breast abscess, non-pregnancy related, with periods of apparent healing and repeated areolar fistula formation. Incidence, risk factors, hypothetic mechanisms of primary / secondary breast MbT infection, microbiological assessment difficulties - related to conventional (smear with special stains as Ziehl Neelsen, and culture on specific solid/liquid media), immunological (proving host competence), and new methods (molecular tests as polymerase chain reaction, and the most advanced method with nanoparticles, delivering fast results, with high accuracy, sensibility, and specificity), the differentials to pyogenic abscesses, other chronic granulomas, and breast cancer, treatments issues are presented from the reviewed literature, focussing on breast location, and complications. One recalls the old concept of „therapeutic antitubercular” test, when all other available assessment steps are usefulness.
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