Study of clinical, imaging and pathological assessment of breast lumps: an observational study
Keywords:Carcinoma breast, Suspicious breast lumps, Triple test
Background: A palpable lump in a woman’s breast could be benign or malignant and it requires prompt evaluation to confirm or exclude cancer. This study aims to establish the correlation between clinical and radiological parameters for provisional diagnosis of breast lumps and the role of histopathology for final diagnosis of these breast lumps.
Methods: Total 275 female patients with palpable breast lumps were included in the study, where a detailed history was recorded and clinical examination was done. All patients underwent ultrasonography of the breast along with fine needle aspiration cytology or histopathology, wherever indicated.
Results: Benign breast lumps were found more commonly in 18-30 years of age group whereas malignant breast lumps were seen more commonly in the 41-60 years age group and the incidence increased with age. Fixity to skin was present in 5.1% and fixity to chest wall was present in 5.8% respectively, and all of these cases turned out to be malignant.
Conclusions: Attributing factors for suspicion of malignant lumps are advanced age, fixity to surrounding structures, presence of ulceration and peau’d orange breast skin appearance. Although for confirmation of malignancy from a suspected breast lump requires either cytology or histopathology of the excised specimen.
Gurav D. Diagnostic approach to palpable breast lump by modified triple test score: a prospective study. J Med Sci Clin Res. 2018;6(12):44-9.
Gøtzsche P, Jørgensen K. Screening for breast cancer with mammography. Cochrane Database Syst Rev. 2013;1469:CD001877.
Deliiski T, Baichev G, Dikov D, Todorova A, Gorchev G. The triple diagnosis of breast diseases. Akush Ginekol. 1998;37(4):33-4.
Neal L, Tortorelli C, Nassar A. Clinician's guide to imaging and pathologic findings in benign breast disease. Mayo Clin Proceed. 2010;85(3):274-9.
Mazari F, Sharma N, Reid D, Horgan K. The need for triple assessment and predictors for diagnosis of breast cancer in patients <40 years of age. Clin Radiol. 2018;73(8):758.
Baykara M, Ozkan Z, Gul Y, Aslan O, Gungor L. Effectiveness of the triple test and its alternatives for breast mass evaluation. J Breast Health. 2013;9(4):195-9.
Chopra R. The Indian scene. J Clin Oncol. 2001;19:106-11.
Thomas JM, Fitzharris BM, Redding WH, Williams JE, Trott PA, Powles TJ, et al. Clinical examination, xeromammography, and fine-needle aspiration Cytology in diagnosis of breast tumor. Br Med J. 1978;2:1139-41.
Khoda L, Kapa B, Singh K, Gojendra T, Singh L, Sharma K. Evaluation of modified triple test (clinical breast examination, ultrasonography, and fine-needle aspiration cytology) in the diagnosis of palpable breast lumps. J Med Soc. 2015;29(1):26.
Patil M, Gurav PD, Shafique MH, Khan A. Diagnostic approach to palpable breast lump by modified triple test score- a prospective study. J Med Sci Clin Res. 2018;6(12):78-85.
Sugathan V, Varghese S, Raji NL. A comparative study of clinico-pathological and radiological features of palpable breast lesions. J Evol Med Dent Sci. 2017;6(10):770-6.
Ajitha MB, Babu V, Singh AC. Comparative study of fine needle aspiration cytology, trucut biopsy and final histopathological examination in breast lumps. Int J Biomed Res. 2017;8(3):34-5.
Egwuonwu OA, Anyanwu S, Chianakwana GU, Ihekwoaba EC. Fibroadenoma: accuracy of clinical diagnosis in females aged 25 years or less. Niger J Clin Pract. 2016;19:336-8.
Richie AJ, Mellonie P. Radiological and cytological correlation of breast lesions with histopathological findings in a tertiary care hospital in costal Karnataka. Int J Contemp Med Res. 2019;6(2):102-8.
Khemka A, Chakrabati N, Shah S, Patel V. Palpable breast lumps: fine-needle aspiration cytology versus histopathology: a correlation of diagnostic accuracy. Int J Surg. 2009;18:75-9.