DOI: http://dx.doi.org/10.18203/2349-2902.isj20184609

Benign and malignant lesions of the breast: clinico-pathological perspective from a government teaching hospital in West Bengal, India

Saurav Sarkar, Arista Lahiri, Soumyajyoti Bandyopadhyay, Snehasish Das, Tamal Chakraborty

Abstract


Background: While breast cancer is one of the most commonly diagnosed cancer more than half of the women develop some benign disease of breast in their lifetime. The current study was conducted to describe the clinico-pathological findings associated with breast diseases and study their relationship.

Methods: A record-based cross-sectional study was conducted on the samples of breast tissue obtained by fine needle aspiration cytology (FNAC) examination. The clinical variables like age, sex, presenting complaint, involved side (right/left/both) etc. were taken from the clinical notes sent, and nature of the aspirate, histopathological diagnosis, nature of the diagnosed disease (benign/malignant), and axillary metastasis were taken as variables from pathological examination.

Results: The mean age of the patients was 33.49 years (±13.24 years) with majority belonging to 20-40 years. Among the 184 specimens examined, 94.57% belonged to female patients. The most frequent presentation was with lump (95.11%). Complaint arising out of right breast (47.83%) were higher compared to left breast (40.76%). Involvement of the supero-lateral quadrant was seen in 75.54%. In 30.44% of the cases the material was bloody or blood-mixed. Majority of the patients (86.41%) were diagnosed with benign disease commonest being fibroadenoma. Ductal carcinoma was the commonest malignant lesion. Younger age group, absence of bloody discharge and absence of peau d’orange were associated with benign lesion in a statistically significant way (p-value <0.001).

Conclusions: In consonance with published literature the findings suggest association of older age group with malignant lesions. Blood-mixed aspirate, peau d’orange appear to be danger signs.


Keywords


Benign, Breast, Breast pathology, Fine needle aspiration cytology, Malignant

Full Text:

PDF

References


World Health Organization. Women and health: today’s evidence tomorrow’s agenda. Geneva: World Organization; 2009:91.

Ayoade BA, Tade AO, Salami BA. Clinical features and pattern of presentation of breast diseases in surgical outpatient clinic of a suburban tertiary hospital in South-West Nigeria. Niger J Surg Off Publ Niger Surg Res Soc. 2012;18(1):13-6.

WHO. International Statistical Classification of Diseases and Related Health Problems. Disorders of breast. ICD-10. 2016. Available at http://apps.who.int/classifications/icd10/browse/2016/en#/N60-N64 Accessed 15 August 2018.

International Statistical Classification of Diseases and Related Health Problems. Malignant neoplasm of breast (C50-C50), ICD-10. 2016. Available at http://apps.who.int/classifications/icd10/browse/2016/en#/C50-C50

Ashing‐Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psych Oncol. 2004;13(6):408-28.

Schwartz SI, Brunicardi FC, eds. Schwartz’s principles of surgery. 9th ed. New York: McGraw-Hill, Medical Pub. Division; 2010:1866.

Rathi M, Khalid M, Budania SK, Mittal A, Verma N. A clinicopathologic study of various breast lesions with cytohistological correlation. Muller J Med Sci Res. 2015;6(1):16-22.

Kuiri DSS, Saha DAK, Nandi M, Ghosh DPK, Sasmal DM, Ranjan DR. Study of pattern of presentation and diagnostic accuracy of FNAC as compared to ultrasonography, in detection of breast cancer among tribal females of Rural West Bengal. IOSR-JDMS. 2015;14(1):5-8.

Shah PP, Shaikh S, Panchbhai S, Vakhariya B. Clinical study of breast lump-triple assessment does help in diagnosing it better. Int Surg J. 2018;5(4):1246.

Center for Disease Control and Prevention. Epi InfoTM. CDC. Available from at https://www.cdc.gov/epiinfo/index.html 17 December 2017.

Murali U, Cunden SM. Clinico-pathological Correlation of breast lumps in Mauritian women. IOSR-JDMS. 2015;14(7):2279-861.

Chalya PL, Manyama M, Rambau PF, Kapesa A, Ngallaba SE, Masalu N, et al. Clinicopathological pattern of benign breast diseases among female patients at a tertiary health institution in Tanzania. Tanzan J Health Res. 2016;18(1).

Shanthi V, Ali K, Rao NM, Krishna BAR. Clinicopathological study of breast lesions in females with assessment of correlation between tumor grade and prognostic factors. J Biosci Technol. 2011;2:367-78.

Wiggett WS, Louw M, Karusseit VOL. The histology of peau d’orange in breast cancer: what are the implications for surgery? South Afr J Surg Suid-Afr Tydskr Vir Chir. 2012;50(3):75-8.

NCI Dictionary of Cancer Terms. National Cancer Institute. Available at https://www.cancer.gov/publications/dictionaries/cancer-terms Accessed 18 August 2018.

Inflammatory Breast Cancer. National Cancer Institute. Available at https://www.cancer.gov/types/breast/ibc-fact-sheet Accessed 18 August 2018.

Buchholz TA. Breast cancer: postmastectomy radiation therapy, locally advanced disease, and inflammatory breast cancer. In: Gunderson LL, Tepper JE, editors. Clinical Radiation Oncology 3rd Edition. Philadelphia: W. B. Saunders; 2012;62:1339-1353.