Diagnosis Of Benign Breast Lesions Research Articles

Diagnosis of Infarcted Breast Lesions on FNAC, a Blustering Fool: Short Case Series.

Fine-needle aspiration cytology (FNAC) is often used as a screening tool. Cytopathologist should be aware of various mimickers of the malignancy. One of these is infarction of benign breast lesions. Careful examination of cytomorphological features will avoid the misdiagnosis of malignancy in such cases. Six cases were diagnosed as benign breast lesion for 4 years and 5 months in our newly established tertiary referral center. Histopathology follow-up was available in one case. Of six cases, three cases (50%) were reported as fibroadenoma with infarction, two cases (33%) as benign breast lesion with infarction favor fibroadenoma, and one as breast lesion with infarction favor phyllodes tumor in view of recurrence. Most were in the second or third decade of their life. All cases showed dyscohesive cells with pyknotic nuclei. Monolayered sheets of necrotic cells were seen in the four cases (66%). Viable cells were seen in four cases. FNAC provides a rapid and accurate diagnosis of benign breast lesions with infarction in the hands of experienced pathologists who can help in better patient care. Small-sized uniform pyknotic nuclei of dyscohesive cells and regular nuclear membranes help to differentiate them from inflammatory and malignant lesions.

An observational study on benign breast diseases in a tertiary healthcare centre in Chengalpettu district

Background: Benign breast disorders constitute the majority of breast complaints presented by young females to a surgical OPD. It is 10 times more common than cancerous conditions and deserves attention due to its high prevalence, impact on woman’s life associated anxiety and possibility of some turning into cancerous conditions. It is divided into aberrations and abnormalities in development, epithelial and stromal proliferations, inflammations and neoplasms. In this study we aim at finding the prevalence, age, clinical presentation of commonest benign breast conditions and its correlation with pathological and radiological studies.Methods: The 98 cases of benign breast diseases between the age group of 15-45 years underwent triple assessment consisting of clinical examination, ultrasonography and fine needle aspiration cytology. Patients who were diagnosed with malignancy were excluded from the study.Results: Out of 98 breast lesions the commonest presentation was breast lump and found most commonly in right upper quadrant. The most common age was 20-30 years and fibroadenosis was most common benign lesion followed by fibroadenoma, mastalgia, breast abscess and nipple discharge.Conclusions: BBDS are a common problem among females in the reproductive age group. It is important to differentiate between fibroadenoma and fibroadenosis. FNAC and ultrasonography are a useful aid in diagnosis of benign breast lesions.

A Cross-Sectional Observational Study to Compare the Role of Ultrasound with Mammography in Women Identified at High Risk for Breast Cancer in a Population in China.

BackgroundCurrently, there is no national breast cancer screening program in China. In countries that have screening programs, screening mammography is used. This study aimed to compare the imaging parameters and diagnostic findings between ultrasound and mammography in women at high risk who had a histologically confirmed diagnosis of breast cancer in a population in China.Material/MethodsA cross-sectional observational study included 1,687 women with a risk score of ≥30, according to the cancer risk assessment model, who underwent breast ultrasound and mammography. Women who had a Breast Imaging-Reporting and Data System (BI-RADS) score of 4 or 5 were identified, and 155 women had breast cancer confirmed by breast biopsy and histology. The ultrasound and mammography findings were evaluated and compared.ResultsBreast ultrasound resulted in significantly fewer inconclusive results (BI-RADS score, 0), when compared with mammography (p=0.046). In cases with a histologically confirmed diagnosis of breast cancer (BI-RADS score, 4), the diagnostic sensitivity of breast ultrasound and mammography were 0.989 and 0.859, respectively. In cases with a histologically confirmed diagnosis of breast cancer (BI-RADS score, 5), the diagnostic sensitivity of breast ultrasound and mammography were 1.000 and 0.984, respectively. In cases with a histologically confirmed diagnosis of benign breast lesions (BI-RADS score, 2), there was no significant difference between breast ultrasound and mammography.ConclusionsIn a population of women in China, breast ultrasound was a more sensitive diagnostic imaging method for women with high risk BI-RADS 4 and 5 breast lesions.

Ultrasound Guided Therapeutic Excisional Vacuum Assisted Biopsy in Fibroadenoma (BIRAD3 Lesions)

Background: Our study showed that ultrasound-guided, vacuum-assisted excision can play an efficient role in the diagnosis of benign breast lesions and is a safe and successful alternative treatment of fibroadenomas. Although the breast fibroadenoma is a common benign breast tumor, the treatment and follow-up of these lesions is still debatable. We suggest that UGVAB, which has a well-documented role in the diagnosis of breast lesions, may provide an option for the definitive treatment of breast fibroadenomas. Objective: The objective of our work was to evaluate ultrasound-guided, vacuum-assisted excision (UGVAE) as an alternative approach in the diagnosis of radiologically benign breast lesions. Patients and Methods: We prospectively evaluated breast lesions excised using VAB between April -October 2017 at Ain-Shams University /interventionl radiology unit at radiology department, which had a proven diagnosis of fibroadenoma. An informed consent form was obtained from each patient of a total of 25 cases ultrasound-guided VABB using biopsy system. All patients have been subjected to breast ultrasound examination. Results: Thirteen patients developed hematomas during UGVAE but none needed surgical intervention, while twelve patients pass with no significant hematomas, with 100% cure rate. None of the patients experienced significant enough pain to require the cessation of the procedure, although 22 (88%) patients reported mild pain and moderate pain (12%) during procedure. At the two week control, 3(12%) patients reported taking paracetamol for mild pain. In ten of them (40%) the pain was strong enough to interfere with sleep. Conclusion: Vacuum assisted Ultrasound-guided biopsy allows real-time imaging, could be performed without breast compression, and is the preferred method if the lesion is detectable with ultrasound.

Cytological evaluation of benign breast lesions with histopathological correlation

Objective: To evaluate diagnostic performance of fine needle aspiration cytology[FNAC] in diagnosis of benign breast lesions. Methods: Women who had FNAC diagnosis of benign breast lesion were followed up with histopathological evaluation to assess the diagnostic accuracy of FNAC. Results: Out of sixty benign cases diagnosed on FNAC, fifty eight cases were benign and one case each of mastitis and fibrocystic disease had infiltrating ductal carcinoma on histopathological examination suggesting 96.7? diagnostic accuracy of FNAC in diagnosing benign breast lesions. Conclusion: The correlation between cytology and histology showed that FNAC is an accurate test in diagnosing and managing benign breast lesions. Keywords: Breast Lump, FNA, Benign Breast disease.

Ultrasound-Guided, Vacuum-Assisted Excision in the Diagnosis and Treatment of Clinically Benign Breast Lesions

Ultrasound-guided, vacuum-assisted biopsy has a definitive role in the diagnosis of breast lesions. Its role in the treatment of benign breast lesions like fibroadenomas has not been established. This is a retrospective review of patients undergoing ultrasound-guided, vacuum-assisted biopsy for clinically benign breast lesions. The procedures were performed in all cases by two consultant radiologists with special interest in breast radiology between February 2002 and January 2004. Patients were followed up in the clinic 6 weeks after the procedure. Seventy-six patients had ultrasound-guided, vacuum-assisted excision of clinically benign breast lesions during this 2-year period. Mean age of the patients was 31 years. Altogether, 86 procedures were performed. Six patients with larger lesions (> 2 cm) had two procedures on separate sitting and 4 patients had separate lesions excised on a later date. Fifty-six patients were identified to have fibroadenomas and had complete excisions as evidenced on scan. Three out of nine patients identified with equivocal disease on fine needle aspiration cytology (FNAC) were found to have cancer following ultrasound-guided, vacuum-assisted excision. One patient who was diagnosed with cancer on FNAC, proved to be fibroadenoma on final histopathology. Four patients developed haematomas following ultrasound-guided, vacuum-assisted excision and all were managed conservatively. Our study shows that ultrasound-guided, vacuum-assisted excision can play an efficient role in the diagnosis of benign breast lesions and is a safe and successful alternative in treatment of fibroadenomas.

Benign pairs. A useful discriminating feature in fine needle aspirates of the breast.

To determine the diagnostic utility of the finding of naked, bipolar nuclei in fine needle aspirates of breast lesions. Aspirate smears from 150 cases of histologically proven benign (77) and malignant (73) breast lesions were evaluated for the presence of stripped, bipolar nuclei in the smear background as singlets as well as closely associated pairs. The presence of such pairs was a more specific indicator of benign entities (present in 70% of benign lesions vs. 1% of carcinomas) when compared to single, bare nuclei alone (present in 94% of benign lesions vs. 45% of carcinomas). Large numbers of such "benign pairs" also strongly favored the diagnosis of fibroadenoma within the benign subgroup. The presence of bipolar nuclear pairs is a valuable addition to the finding of singlets in the diagnosis of benign breast lesions and their subclassification.

Fine-Needle Aspiration of the Breast

One of the numerous controversial issues related to the clinical management of breast cancer is the role of fine-needle aspiration (FNA). Despite its enthusiastic use in the diagnosis of thyroid nodules, its application to breast abnormalities has been accepted reluctantly. Breast FNA necessitates technical and interpretative skill and continual practice and is not 100% accurate. It also entails an additional, although moderate, expense. To assess the accuracy and determine the possible role of FNA at our institution, we performed both FNA and excisional biopsy in 100 unselected women with palpable breast nodules and correlated the cytologic and histologic findings. Our results were similar to those in previously published studies. FNA had a false-negative rate of 6%, no false-positive results, and an accuracy of 94%. After reviewing the potential assets and liabilities of this technique, we believe that breast FNA may add a measure of confidence in the diagnosis of benign breast lesions, provides a safeguard for preventing misdiagnosis of malignant lesions, and might expedite and reduce the cost of managing both primary and recurrent breast cancer.