A 13-year-old girl presented to the clinic with a lump in her breast. According to her, the mass first appeared 2 years ago and then increased gradually over time. However, she did not have any discharge from her breast or associated fever. Her history revealed cardiac valve repair because of rheumatic heart disease, more than 2 years ago.
Examination and Investigations
The doctors did an ultrasound of her left breast which confirmed an irregular mass. The association of the mass with oedema of subcutaneous tissues led to the differential of an infection. However, they had also considered malignancy in their list of differentials. Hence, they took a biopsy and sent it for a histopathological assay. The results showed the presence of inflammatory cells (lymphocytes and macrophages) within the mass, a finding consistent with a chronic abscess.
The doctors gave her a course of antibiotics for treatment. However, her symptoms did not improve nor did the mass reduce in size, which made the excision of the mass imperative. While removing the mass, doctors found it attached to the underlying rib. Moreover, they also discovered a wire protruding from above the rib. It was confirmed to be a retained and displaced epicardial pacemaker wire, being the focus of the infection.
Points to Keep in Mind When Dealing With a Breast Mass
Masses or lumps in the breast are common complaints in post-menopausal women as well as women of reproductive age. They usually reflect breast cancers. However, diagnosis of cancer should only be made after a biopsy because many other conditions are associated with a breast mass, for example, mammary duct ectasia or periductal mastitis. Despite that, breast masses due to foreign bodies are very rare. Moreover, the girl’s young age and asymptomatic presentation make the case more unusual and only the second of its kind.
