Clinical and histological characteristics of breast lumps: A 20-year single private sector tertiary care center experience

Abstract

Background and objective: The presence of a breast lump is an alarming experience. This is because of the growing awareness of breast cancer among the public. Therefore, a comprehensive diagnosis of breast lumps is vital. This study aims to identify the clinical and histological characteristics of breast lumps of patients presenting to a tertiary care center in Colombo, Sri Lanka. Methods: This 20 year, retrospective study analyzed the clinical and histological characteristics of all patients with breast lumps who were admitted only to Nawaloka Hospital, Colombo from 2003 to 2023. Data were retrieved through past medical records and a computer-based health information system from Nawaloka Hospital. A general surgeon analyzed all the records. The records were analyzed with relation to demographics, presenting symptoms, presence of a lump or mass, and histological diagnosis. This study was aimed to determine the characteristics of breast lumps in a selected sample of patients who were admitted with breast lumps to a single private sector tertiary care hospital. Ethical clearance was granted. No conflict of interest. Results: Total of 352 patients had breast lumps [female-342 (97.1%): male-10(2.9%)]. Data from 342 female and 10 male patients who were admitted with breast lumps or masses were analyzed. There were 252 /352 self-referrals, 60 / 352 referrals were from general practitioners and 40 / 352 were referred following screening. Most females were 21 to 50 years (n=219, 64%). Ninety-seven per cent of the female patients had palpable breast lumps. Most males with breast lumps were in the age group of 51-60 years. Males had relatively larger lumps (> 2cm, 80%) at the time of their presentation. In both genders, the most common quadrant for occurrence of breast lumps was the upper outer quadrant (F: 55% & M: 60%). Fibroadenoma was the commonest variety of lump in both sexes (F: 49% & M: 60%). However, most males who presented with breast lumps were found to have breast cancer (M: 40% vs. F: 10%). Histologically, invasive carcinoma of no specific type (NST) was the most common type (M: 75% & F: 63%). Thirty-five female patients had carcinoma, ten were below the age of 50 years, and two were in their early 30s. Conclusion: Our study sample showed that most of the patients were females. The most common benign breast lump was fibroadenoma and the malignant variant was invasive carcinoma of no specific type (NST). Furthermore, it showed that at the time of presentations males had larger breast lumps with and raised percentage of malignant breast lumps.