Study of spectrum and clinical profile of benign breast disease in the rural area: is there any change
Keywords:Benign breast diseases, Fibroadenoma, Fibrocystic disease, Mastitis
Background: Recent understanding of pathophysiology and health awareness may have impact on spectrum of benign breast disease (BBD) in rural area. We have analyzed clinical data of 88 cases of BBD for spectrum and clinical profile to compare with present studies.
Methods: Clinical records of 88 cases of BBD were reviewed for demographic details, clinical presentation, management and outcome. Recent literature related to BBD in rural area was searched using various search engines. Results of our study were compared with recent studies.
Results: Fibroadenoma (FA) was most common condition followed by fibrocystic disease. BBD were common in third decade 46 (52.3%). Lump was present in 87 cases. Lump was painful in 45 (52.3%), and associated with fever in 15 (17.1%) cases. Fine needle aspiration cytology and ultrasound was done in 70 and 32 patients in which diagnostic accuracy with histopathology was seen in 69.7% and 56.2% respectively. Surgical treatment included lumpectomy, lump excision, mastectomy, drainage with debridement and axillary clearance. Three patients of breast tuberculosis were treated with 9 months AKT. When compared with recent studies, over all spectrum was same expect chronic abscess presenting as lump was more in our series.
Conclusions: Our study revealed benign neoplasms, inflammatory condition and tumor like lesions in 43.1%, 14.6% and 13.8% cases respectively. FA was the most common lesion. BBD were common in third decade. Except the chronic mastitis, incidence of various types of benign lesions was comparable with those found in other studies. There is not much change in overall spectrum of benign breast disease.
Romrell LJ, Bland K. Anatomy of Breast, Axilla, Chestwall, and Related Metastatic Sites. Chapter 2, The Breast - Comprehensive Management of Benign and Malignant Disorders. 3rd Ed., Vol. 1 Blend Kirby I, Copeland III Edward M., W.B. Saunders Company, Philadelphia; 2004: 21-42.
Khemka A, Chakravarti N, Shah S, Patel V. Palpable breast lumps: Fine needle aspiration cytology versus histopathology, a correlation of diagnostic accuracy. Int J Surg. 2009;18:1.
Cole P, Mark E, Kaplan S. Incidence rates and risk factors of benign breast neoplasms. Am J Epidemiol. 1978;108:112-20.
Hutchinson WB, Thomas DB, Hamlin WB, Roth GJ, Peterson AV, Williams B. Risk of breast cancer in women with benign breast disease. J Natl Cancer Inst. 1980;65:13-20.
Kelsey JL, Gammon MD. Epidemiology of breast cancer. Epidemiol Rev. 1990;12:228-40.
Sarnelli R, Squartini F. Fibrocystic condition and at-risk lesions in asymptomatic breasts: A morphologic study of postmenopausal women. Clin Exp Obstet Gynecol. 1991;18:271-9.
Cook MG, Rohan TE. The patho-epidemiology of benign proliferative epithelial disorders of the female breast. J Pathol. 1985;146:1-15.
Mansel RE. Benign breast disease. Practitioner. 1982;232:830-7.
Sainsbury RC. Breast, In: Norman WS, Bulstrode CJ, Ronan P, O’Connel, editors. Bailey and Love’s Short Practice of Surgery. 25th ed. London: Edward Arnold Ltd.; 2008:827-835.
Nishant K, Kumari M. Benign Breast Diseases in Tertiary Center in North Bihar: A Clinico-pathological Study. Int J Sci Stud. 2016;4(2):56-9.
Kavasseri LJ, Narayan AS, Subbaraju K, Palaniappan M, Partha N. Profile of Breast Diseases in Post Pubertal Women Assessed by Clinical Breast Examination: A Community Based Study in Rural Pondicherry. J Clin Diagnostic Res. 2016;10(2):7-11.
Love SM, Gelman RS, Silen W. Fibrocystic disease of the breast: a non-disease. N Eng J Med. 1982;309:1010-14.
Michael GJ. Benign condition of the breast Chapter-21.1, Oxford text book of surgery Peter J. Morris and Ronald A. Malt Eds, 2nd ed., New York: Oxford Medical Publication; 2000:1169-1189.
Haque R, Tyagi SP, Khan MH, Gahlaut YVS. Breast lesions, a clinicopathological study of 200 cases of breast lumps. Ind J Surg. 1980;42:419-25.
Gupta JC. Breast lumps in Jabalpur area - review of 1104 cases. Indian J Surg. 1983;45:268-73.
Khanna S. Spectrum of benign breast diseases - a retrospective study of 22 years. IJS. 1988:169-75.
Khanna R. Spectrum of breast Disease in Young females A retrospective study of 1315 patients. Ind J Patho Micro. 1998;41(4):397-401.
Rangabashyam N, Gnanaprakasan D, Krishnaraj B, Manohar V, Vijayalakshmi SR. Spectrum of benign breast lesions in Madras. J R Coll Surg Edinb. 1983;28:369-73.
Seema N, Irbinder KB, Prachi A, Vinay K, Goyal K, Shah P, et al. Clinico-Pathological Study on Benign Breast Diseases in Gurugramncr. IOSR J Dent Med Sci (IOSR-JDMS). 2018;17(4):59-62.
Shanker MR, Reddy T, Prajwal S. Benign Breast Disease among the Rural Population: A Clinical Study. IJSS J Surg. 2017;3(1):30-7.
Ajay KK, Umesh J, Karandeep S. Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India. Asian Pac J Cancer Prev. 2017;14(12):7257-60.
Shilpa K, Ajay K, Sarada K. Characteristics of surgically treated benign breast disease. Int J Surg Sci. 2017;1(1):30-2.
Narendra Y, Sajani P, Ahmad S, Omkar H. Clinical study of Benign breast diseases. Prospective Med Res. 2017;5(2):41-4.
Martin PM, Kuttenn F, Serment H, Jarvis MP. Studies on clinical, hormonal and pathological correlations in breast fibroadenomas. J Steroid Biochem. 1978;9(12):1251-5.
Lee BJ, Pack GT. Giant intracanalicular fiixo-adenomyxoma of the breast. The so-called cysto- sarcoma phyllodes mammae of Johannes Miller. Am J Cancer. 1931;15:2583-609.
Jane L, Arthur PS, Phylloids C. Annual Reports: Supplemental and Organization. Cancer. 1954;7:335-53.
Michael DR, Perry RR, Hsiu JG, Barranco SC. Phyllodes Tumours. Am J of Surg. 1993;165:376-79.
Cooper AL, Rees, Orme B. Green; Illustrations of the Diseases of the Breast. London. 1829.
Indumathi CK, Anand A, Chitra D, Priti LR. Tuberculosis of the Breast in an Adolescent Girl: A Rare Presentation. J Tropical Pediatrics. 2006;53(2):133-4.
Sharma PK, Babel AL, Yadav SS. Tuberculosis of breast (study of 7 cases). J Postgrad Med. 1991;37:24-6.
Meral S, Canan G, Mikdat B. Isolated Primary Breast Tuberculosis - Report of three cases and review of literature. Clinics. 2009;64(6):607-10.
Samal D, Sahoo R, Maity K, Patra K, Abdullah U. Tuberculosis of breast: an Indian scenario. Int Surg J. 2018;5:2137-41.
Brown S, Thekkinkattil DK. Tuberculous cold abscess of breast: an unusual presentation in a male patient. Gland Surg. 2016;5(3):361-5.
Hatwal D, Suri V, Mishra JP, Joshi C. Tubercular Mastitis is Common in Garhwal Region of Uttarakhand: Clinico Pathological Features of 14 Cases. J Clin Diagnostic Res. 2011;5(8):1569-73.
Helmuth V. Current development Fibrocystic breast disease pathophysiology, pathomorphology, clinical picture and management. Am J Obst Gynecol. 1986;154:1.
Bannayan GA, Hajdu SI. Gynecomastia: Clinicopathologic study of 351 cases. Am J Clin Pathol. 1972;57:431-7.