Background: Tuberculosis of the breast (Mammary tuberculosis) is a rare condition that can mimic breast cancer or other benign breast diseases such as fibro adenomas. It is important to consider it in the differential diagnosis of a breast lump, especially in regions where tuberculosis is endemic such as Africa & India.

Case presentation:  We report a case of a 41-year-old Sudanese female who presented with a painful lump in her right breast and enlarged lymph nodes in her armpit and cervical region. Additionally she also had fever with night sweating, fatigue coupled with an unintentional weight loss, her labs show three figured erythrocyte sedimentation rate. Ultrasound, mammogram and biopsies confirmed the diagnosis of tuberculosis of the breast and negative for other conditions such as breast adenomas & cancers. She was put on quadruple therapy for two months and dual therapy for 4 months of anti-tuberculosis drugs, but her treatment was interrupted for three months due to war and displacement in Khartoum. She resumed treatment and showed improvement in her all symptoms and signs.

Conclusion: This case highlights the challenges of diagnosing and treating tuberculosis of the breast in a resource-limited setting. It also underscores the importance of early diagnosis and treatment, as well as the effectiveness of the fixed-dose combination of anti-tuberculosis drugs.

Dr. Isra Mufadal Abdulkareem bur is Specialist of Respiratory Medicine, MD. SMSB – SMC MBBS, University of Gadarif – Faculty of Medicine & Health Sciences, Sudan.