Evaluation Of Breast Lumps Research Articles

Cytological Evaluation of Palpable Non-Neoplastic Breast Lesions among Women attended from Rural Community of Bangladesh: A Retrospective Cross-Sectional Study

Background: Non-neoplastic palpable breast disease is one of the most common disorders from which women suffer throughout the world. The use of fine-needle aspiration cytology (FNAC) method has proven to be quick, simple and cost-effective with minimum risk of complications in the evaluation of breast lumps. Objective: This study was planned to find out the common causes of various types of non-neoplastic breast lesions of female at different ages through fine needle aspiration cytology. Methodology: The retrospective cross-sectional study was carried out in the Department of Pathology at Monno Medical College& Hospital, Manikganj, Bangladesh. It lasted 2 years 6 months from July 1, 2019 to December 31, 2021. This study examined all breast lumps found in female patients. For data analysis, the patient's age and FNAC report were recorded. Aspirates were done using 5ml/10ml syringe and 23-gauge needle. Smears were stained with Papanicolaou stain. Results: The study included total 349 female patients with breast lesion. Among these, non-neoplastic lesions were 183(52.44%) cases and neoplastic lesions were 166(47.56%) cases. Among the lesions, 105(30.08%) cases were in fibrocystic changes; 28(8.02%) cases were in non-suppurative mastitis; 24(6.87%) cases were in suppurative mastitis (abscess), 14(4.01%) cases were in granulomatous mastitis. About 45(42.88%) cases of Fibrocystic changes, 13(44.84%) cases of non-suppurative mastitis and 9(37.5%) cases of Suppurative mastitis (abscess) were in the age group 21 to 30 years, 21 to 30 years and 41 to 50 years respectively. Conclusion: Fibrocystic changes are the commonest lesion in this study. Journal of Monno Medical College June, 2024; 10 (1):07-12

The Role of Fine-Needle Aspiration Cytology in the Evaluation of Breast Lumps.

Background Breast cancer is the most frequently diagnosed cancer in women worldwide, accounting for more than one in ten new cancer cases each year. It ranks as the second leading cause of cancer-related mortality among women. The majority of patients present with palpable breast lumps. Effective surgical management of breast cancer largely depends on accurate preoperative pathological diagnosis. This study evaluates the diagnostic accuracy and prognostic implications of fine-needle aspiration cytology (FNAC) compared with core needle biopsy (CNB) in breast carcinoma. Objectives The objectives of this study are to assess the sensitivity and specificity of FNACand CNB, to compare the diagnostic accuracy of FNAC and CNB against histopathological findings from gross specimens in the evaluation of breast lumps, and to identify and examine the limitations associated with both FNAC and CNB procedures. Materials and methods This study included female patients presenting with clinically suspicious palpable breast lumps at the General Surgery OPD of Bankura Sammilani Medical College and Hospital, Bankura. All patients underwent FNAC followed by CNB. The cytological and CNB diagnoses were compared with the final pathological diagnosis obtained from excisional biopsy. Results The study included 44 female patients aged 20 to 70 years. The most common age group for breast carcinoma was 50-59 years (36.36%). Malignancy was diagnosed in 75% of cases (33/44), with right breast involvement (65%) being more common than the left. The upper outer quadrant (59%) was the most frequently affected area. Among the 33 confirmed malignant cases, 69.70% had lesions larger than 5 cm. FNAC demonstrated a sensitivity of 93.93%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 84.61%, and diagnostic accuracy of 95.45%. CNB showed a sensitivity of 96.97%, specificity of 100%, PPV of 100%, NPV of 91.67%, and diagnostic accuracy of 97.73%. Both methods correlated significantly with the final histopathology results (p < 0.05). FNAC identified ductal carcinoma in 93.55% of cases, while CNB identified it in 96.77%. Conclusion CNBprovides additional information on receptor status but is more resource-intensive. FNACremains a cost-effective and time-efficient first-line diagnostic tool, especially in resource-constrained settings like rural India. FNAC should be employed for initial diagnosis, with CNB reserved for cases requiring further clarification.

Assessing the Accuracy of Ultrasonography and Biopsy Necessity in the Management of Breast Lumps in Women Less than 40 Years

Abstract Background: Following recommended guidelines, palpable breast lumps in young women should be subjected to clinical–radiologic evaluation and tissue diagnosis where necessary. However, in our local practice, most benign breast lumps are also subjected to excision biopsy. Ultrasonography is the modality of choice in the evaluation of palpable breast lumps in young women. Aim: This study aims to determine the accuracy of ultrasonography and the necessity of tissue biopsy in the management of palpable breast lumps in women less than 40 years of age and to determine lesions that can safely be managed conservatively based on histological diagnosis. Materials and Methods: This was a prospective cross-sectional study of 87 adult females who had breast US and biopsy for palpable breast lumps in a tertiary healthcare center over a period of 10 months (July 2020–May 2021). Results: The age range of the women was 18–39 years (mean 27.9 ± 7.09 years). Benign lesions were noted in 86.2% of patients. No malignancy was detected in women &lt; 25 years. Ultrasonography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 100%, 93.4%, 70.6%, 100%, and 94.3%, respectively, in differentiating benign from malignant breast lumps following tissue diagnosis. Conclusion: Ultrasonography and tissue biopsy are vital in the evaluation of breast lumps in women less than 40 years of age. Most (86.2%) of the lumps were benign, and no malignancy was detected in women &lt; 25 years. The high accuracy of ultrasonography in distinguishing benign from malignant lesions suggests the need for conservative management of benign lumps in young women.

Evaluation of Breast Lump: Comparison of Ultra-Sonographic and CT USG-Guided Histopathological Findings

Evaluation of Breast Lump: Comparison of Ultra-Sonographic and CT USG-Guided Histopathological Findings

Role of Triple Test in Evaluating Breast Lumps

Breast tissue undergoes constant physiological changes in a woman’s life because of influence of endocrine hormones during and after reproductive life. These changes may present as pain, lumpiness or both in the breast. Breast lumps are feared for cancer. Thus, it is important for women with a breast lump to receive appropriate evaluation. Clinical breast examination is first step in evaluation of breast lump. The diagnostic sensitivity of clinical breast examination is high (98%) whereas its specificity is low, averaging 48%. Ultrasound is preferred in evaluation of radiologically dense breasts and in the study of breasts with augmentation mammoplasties. Micro-calcifications on mammography are considered to be important signs of breast cancer. X-ray mammography detects microcalcifications in 30–50% of breast cancers. FNAC is a cheap, cost effective and readily available routine diagnostic with a sensitivity ranging between 89% to 98% and specificity between 98% to 100% for palpable breast lumps.&#x0D; When combined together triple test achieves a higher sensitivity, specificity and diagnostic accuracy than any of the investigations taken alone. We conducted a prospective study to evaluate breast masses by clinical assessment, imaging and pathological examination. Results were compared with histopathology. We concluded that triple assessment in breast lumps gives superior results than any of its modalities taken alone.

ANALYSE AND CLASSIFY VARIOUS BREAST LESIONS ON FNAC WITH SPECIAL REFERENCE TO IAC STANDARDISED REPORTING SYSTEM: A RETROSPECTIVE ANALYSIS OF 300 CASES

Introduction: Breast lumps are the common manifestations in clinical practice. For uniform reporting, better diagnostic clarity and uniform patient management International Academy of Cytology (IAC) has classified reporting of breast Fine needle aspiration cytology (FNAC) into 5 tier yokohama reporting system (C1 to C5). Material and Methods: Present study is a retrospective study done in Department of Pathology, GSVM medical college, Kanpur over a period of 12 month (December 2020 to November 2021). Total 300 cases of FNAC breast smears were reviewed and classified according to IAC reporting system (C1 to C5). Results: In our study we had total 300 cases in 12 month period with female patients (285) out numbered male patients (15). On age wise distribution we get maximum no of cases in 2nd and 3rd decade. On categorization of breast lesions according to IAC Yokohama reporting system out of total 300 cases we get C1 lesions in 09(3.0%)cases , C2 lesions in 184(61.3%) cases, C3 lesions in 26(8.6%) cases, C4 lesions in 11(3.6%) cases and C5 lesions in 70(23.3%) cases. Conclusion: Use of FNAC method for evaluation of breast lump for preoperative management is quick, simple and cost effective, with IAC reporting system we can uniformily classify breast FNA cytology for better patient management and better guidance to clinician.

Evaluation of breast lumps by HRUSG and its correlation with FNAC findings in a teaching hospital

Background: High resolution ultrasonography is useful investigation modality for evaluation of breast lumps.Aim of the study: To study the ultrasonographic features of breast lumps and to correlate the findings with fine needle aspiration cytology.Materials and Methods: A prospective study done on 70 patients of breast lumps who attended department of Radiology, over a period 2 years ie, from January 2018 to November 2020. Results: In the Present study on HRUSG breast 60 cases (85.7%) were circumscribed masses and 10 cases (14.2%) were not circumscribed masses. Calcification and necrosis were noted in 07 malignant cases. 09(12.8%) of our malignant cases showed markedly hypoechoic echotexture. Conclusion: Specificity of HRUSG in diagnosing breast lumps was found to be 98.3% in our study.

Evaluation of Breast Lumps by Ultrasound and Correlation with Histological Findings

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis.&#x0D; Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison.&#x0D; Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant.&#x0D; Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient.&#x0D; Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12

Triple Assessment in Evaluation of Breast Lump

Triple Assessment in Evaluation of Breast Lump

Epidemiology of benign breast lumps, is it changing: a prospective study

Background: There are wide range of benign breast diseases reported from India. Breast lumps are one of the commonest presentations. Although most of the breast lumps are benign but patient become anxious due to fear of malignancy. Due to this, there is an increase in the use of screening mammography and the fine needle aspiration cytology (FNAC) or core needle biopsy (CNB), most of which yield benign findings. This study is aimed to evaluate the incidence of different types of benign breast lumps in respect to age, size, side and site, relation with parity and use of oral contraceptive pills and analyses of this result in relation with the past and recent study on benign breast diseases.Methods: This study was conducted at Rajendra Institute of Medical Sciences, Ranchi (India) over a period of one and half years. Inclusion criteria was the cases with palpable breast lumps which were reported benign on either FNAC or CNB and exclusion criteria was the cases with breast malignancy and inflammatory breast lumps.Results: Most common benign breast lump (BBL) was fibroadenoma followed by fibrocystic disease of breast. Fibroadenoma was mainly presented with lump only whereas fibrocystic diseases of breast presented with lump and pain. Most of the BBL was found in nullipara and OCP non-users.Conclusions: Epidemiology of BBL is still the same when analyzed with past and recent study on the benign breast diseases. Triple assessment remains the key in the evaluation of breast lumps.

Evaluation of breast lump using elastography, histopathology and its diagnostic accuracy

Background: Current era has brought with it a dramatic climb in the incidence of malignancies especially breast carcinoma among females. It is known to be top most diagnosed life-threatening malignancy in females across the world. Thus, there is need for an imaging modality that helps in minimizing any delay in treatment initiation and avoids unnecessary biopsy. Elastography is a technique based on the concept that hardness of tissue increases proportionately with pathology developing within it compared to the tissue parenchyma surrounding it.Methods: A prospective cross-sectional study was carried out at JSS Hospital, Mysuru enrolling 90 patients who consented for the study. Patients who gave history of breast lump were admitted and evaluated with detailed history, clinical examination, followed by radiological and pathological investigation. Statistical methods were applied and sensitivity and specificity of B-Mode USG and elastography were determined. The diagnosis was confirmed by histopathology of the specimen.Results: Out of 90 patients, 46 lesions were benign and 44 were malignant. The sensitivity, specificity and diagnostic accuracy of B-mode USG was calculated to be 71.74%, 90.91% and 81.11% and that for elastography was 95.65%, 68.18% and 82.22% respectively.Conclusions: In this study, elastography may complement conventional B-mode USG to improve the diagnostic performance.

Spontaneous infarction in fibroadenoma of breast: a rare pathological finding in a common pathological entity

Fibroadenoma is one of the most prevalent benign tumour in adolescent women. It accounts for 20% of all benign breast tumours. Spontaneous infarction in fibroadenoma is very unwonted and mostly, it is associated with gravidity or lactation. Infarction can additionally occur as a complication of antecedent fine-needle aspiration biopsy. At the institution during 2-years period we incidentally found three such cases of spontaneous infarction of fibroadenoma over varied age groups which surprised us. So, reviewed the literature and presented our findings. Three fibroadenomas with features of central necrosis were diagnosed on excision and biopsy. Spontaneous infarction within fibroadenoma is a rare occurrence. It causes diagnostic difficulties, hence conscientious search and possibility of this entity should be must during the evaluation of breast lump.

A Clinicopathologic Study of Various Breast Lesions by Fine Needle Aspiration Cytology (FNAC)

Background: The expected and significant role of cytological diagnosis is to distinguish benign from malignant processes. Fine needle aspiration cytology (FNAC) of the breast has two main goals. One is to confirm a radiological and clinical benign lesion and avoid unnecessary surgery and the other is to confirm a malignant diagnosis and allow definite treatment planning. Methods: In breast lesions, rapid diagnosis by aspiration cytology can be particularly useful for allaying the apprehension and anxiety of the patient whose apparent solid mass may turn to be a cyst, thus reducing the anguish and morbidity associated with unnecessary surgical procedures. If the lesions turn out to be malignant, the patient can be referred for immediate treatment on priority so that treatment is not unnecessarily delayed. Thus, aspiration cytology is used more and more in the diagnosis of benign and malignant lesions of the breast. It is a cost-effective and safe method that can differentiate benign and malignant lesions accurately. In advanced carcinoma or unwilling patients for surgery, it can form the basis of management. The objective of this study was to analyze cases of FNAC of breast lesions. Results: This study was a cross-sectional study including all the patients with breast lump who attended Dhaka Community Medical college Hospital for FNAC. A total 50 cases of all ages and both sexes were included in this study. Smears made from aspirated material were collected and examined. Most of the aspirates were from females. There were more benign lesions (43 cases) as compared to malignant cases (seven cases). Fibroadenomas were the most benign lesion of breast. The age of malignant cases ranged from 21 to 60 years with a majority of cases in the age group of 41 - 50 years (four cases, 57.1%). Conclusion: FNAC is less time-consuming, safe, useful and highly accurate technique for breast masses and can segregate benign and malignant lesions with accuracy. Triple assessment by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps. The clinical and radiological presentations of both benign and malignant lesions can be similar - as a hypoechoic focal mass, occasionally inflammatory lesions may mimic mass-like lesions or appears as non-homogenous regions on radiographs. Here, FNAC can play a major decisive diagnostic role and minimizing the requirement of biopsy. J Curr Surg. 2018;8(3-4):27-31 doi: https://doi.org/10.14740/jcs366w

Efficacy of Triple Test Score in Evaluation of Breast Lumps: A One Year Prospective Study

Efficacy of Triple Test Score in Evaluation of Breast Lumps: A One Year Prospective Study

Clinical radiological and pathological assessment of benign breast lumps: our institutional experience

Background: With increased awareness about breast cancer, many women with breast lumps are attending clinics. Though benign breast lumps are most common, they may be associated with morbidity and have become cause for concern to patients. Triple assessment by clinical, radiological and pathological examination is a standard approach in the evaluation of breast lumps. Even in cases of benign breast diseases, multimodality tests are being preferred to give reassurance to patients. This study was aimed to study distribution of various benign breast lumps in relation to age at presentation, to identify sensitivity and specificity of clinical breast examination, Ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods in the evaluation of benign breast lumps and to compare with final histopathological diagnosis.Methods: A retrospective study was conducted in department of general surgery at Malla Reddy institute of medical sciences, Hyderabad from August 2013 to July 2017. 202 females with benign breast lumps were evaluated by clinical breast examination, ultrasonography (USG) and Fine needle aspiration cytology (FNAC) methods. All patients underwent excision biopsy of lump. Final histopathological report was taken as reference standard.Results: Fibroadenoma was most common in 2nd decade. Clinical breast examination and USG showed good sensitivity but less specificity than FNAC. FNAC showed both good sensitivity and specificity. There was very good degree of agreement between FNAC and histopathological diagnosis (Kappa=0.911).Conclusions: Good clinical examination can give accurate preoperative diagnosis of benign breast lumps. Triple assessment by clinical breast examination, USG and FNAC can be useful in the evaluation of benign breast lumps.

Evaluation of Breast Lump by Fine Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology (FNAC) is the important part of triple assessment in diagnosing the palpable breast lump. It categorizes the lesion into benign, malignant and its subtypes. It can also identify the residual diseases after treatment.Methods: It was a cross sectional descriptive study of cases of breast lump carried out during June 2015 to May 2016 in the Department of Pathology, Gandaki Medical College Teaching Hospital, Pokhara, Nepal. All the patients presenting in Pathology Department with history of breast lump were examined in detail. FNAC was done by standard procedure; smears were prepared and stained with Giemsa and pap for evaluation. Histopathology slides were stained with hematoxylin and eosin stain and evaluated by pathologists in Gandaki Medical College Teaching Hospital.Results: The study showed that, fibroadenoma of breast is the commonest benign lesion among the young populations. Only 13.11% of breast lump is malignant in the elderly population.Conclusion: FNAC is one of the safest and cheapest procedure that can be done in outpatient department for the diagnosis of breast lump. And there is no significant difference in diagnosis made by FNAC and histopatholgy examination. Journal of Gandaki Medical CollegeVolume, 09, Number 2, July December 2016, Page: 38-42

Diagnostic Accuracy of FNAC in Evaluation of Breast Lumps

Background and objectives: This study was conducted to compare the diagnostic accuracy of fine needle aspiration cytology (FNAC)in differentiating the benign and malignant lesions of palpable breast lump with histopathological correlation. Methods: This study was conducted at MNR MEDICAL COLLEGE AND HOSPITAL, Sangareddy , Telangana. The study included 50 patients who presented with palpable breast lumps to the surgical out-patient department. Thorough physical examination was done and the patients were subjected to fine needle aspiration cytology of the palpable breast lump. The cytological examination was classified as: Insufficient sample - C1, Benign - C2, Probably Benign - C3, Suspicious of malignancy - C4, Malignant - C5.All these patients were subjected to open/excision biopsy followed by histopathological examination. The diagnostic accuracy of the fine-needle aspiration was then compared with the gold standard histopathology. Results: Most of the cases were of benign pathology of which Fibroadenoma were most common (64%). It was seen that all the patients were female patients in the age group of 15-75 years. Majority of the lumps were found to be in the upper outer quadrant (46%). The sensitivity of fine needle aspiration cytology was found to be 83.33% , The specificity 100%, Positive predictive value 100% and Negative predictive value 97.77% . Conclusion: In patients with a palpable breast lump fine needle aspiration cytology can help to rule out a malignant lesion. This can hence afford as a cost –effective method in diagnosing breast lesions. Also due to its good tolerability and high diagnostic accuracy the patient need not be subjected to further evaluation which helps in the psychological well being of the patient. But, FNAC results when negative or suspicious should be correlated with clinical examination and imaging findings to prevent false positives and false negatives. A diagnosis suspicious for malignancy should be confirmed by open biopsy.

Diagnostic Accuracy of Fine Needle Aspiration Cytology in Benign and Malignant Breast Lesions

Background: Fine needle aspiration cytology (FNAC) or core biopsy form an integral component of the triple test which is being performed as a pre-operative test to evaluate breast lump. Aim: To study the cytomorphological pattern of breast lesions in a tertiary care hospital of Central India and to find out the accuracy of FNAC in diagnosing benign and malignant lesions of breast. Method: 200 patients presenting as breast lumps were evaluated by FNAC and correlated with histology. Result: Fibroadenoma was most common benign lesion while Infiltrating duct carcinoma was most common malignant lesion reported. Sensitivity of FNAC was 99.25% for benign lesions and 95% for malignant lesions. Specificity and PPV of FNAC in diagnosing benign lesions were 95% and 97.79% respectively while that for malignant cases were 99.25% and 98.27% respectively. The diagnostic accuracy of FNAC was 97.94% in the present study. Conclusion: FNAC serves as a rapid, economical and reliable tool for the evaluation of breast lumps. Key words: Fine needle aspiration cytology, Benign breast lesions, Malignant breast lesions, FNAC

Role of Mammography Combined with Ultrasonography in Evaluation of Breast Lump

Breast cancer is one of the major health problems in the world. Specially, in developing countries like ours, it is a major problem as patients present late in hospital. Hence, early diagnosis is important to reduce morbidity and mortality due to breast cancer. Mammography and Ultrasonography are two important imaging techniques to detect breast pathology. This study has been done to evaluate the role of mammography independently and mammography combined with Ultrasonography to diagnose breast lesions. This study was a prospective study conducted in Radiology department of Manipal Teaching Hospital for a period of 18 months. Total of 91 patients of more than 30 years presenting with breast lump were included in study. Mammography was performed in all cases followed by Ultrasonography. Findings were noted according to Breast Imaging Reporting and Data System (BIRADS). FNAC was done for all lumps with or without USG guidance and correlated with imaging findings. Mean age is our study was 44 +/- 7.6 years. Maximum number of patients presenting with breast lump was in the age group of 41-50 years (52.7 %). Benign lump was seen in 74.7 % of patients and malignant lump was seen in 25.3 % of patients. Sensitivity and specificity of mammography in differentiating benign from malignant lesions were 90.9 % and 92.7 % respectively. Mammogram was inconclusive in 15.4 % of patients of age group less than 50 years. Sensitivity and specificity of mammography combined with USG increased to 95.65 % and 95.58 % respectively. Combined USG and mammography has high sensitivity and specificity in diagnosing breast lesions. Hence, these two imaging modalities should be combined for evaluating breast pathology, especially in younger patients with dense breast.

Correlation of Fine Needle Aspiration Cytology and Histopathology Diagnosis in the Evaluation of Breast Lumps

Background: A large number of patients have been suffer from breast cancer worldwide and this trend is increasing. It is difficult to determine whether a lump is benign or malignant from clinical assessment; thus, the need for micropic and tissue analysis arises. Methods: This comparative retrospective cross sectional study was conducted in the Department of Pathology, Rehman Medical Institute, Peshawar, Pakistan from January 2006 to March 2013, to determine the value of fine needle aspiration cytology (FNAC) in the diagnosis of breast lump and to compare the result of FNAC with histological diagnosis to assess its accuracy. Results: Seventy-four cases with breast lumps were presented for FNAC. Of these, 32.4% were reported as a C2 lesion, 4.1% were reported as benign with atypical cells (C3), 8.1% cases were suspicious for malignancy (C4), and 55.4% were positive for malignancy (C5). On histopathology examination, out of 24 cases which were reported as C2 lesions, 95.8% were benign and 4.1% turned out to be invasive ductal carcinoma. Of the cases that presented as C3 lesions, one was diagnosed as benign duct ectasia, one with ductal carcinoma in situ, and one with invasive ductal carcinoma on histopathological examination. The cases that were diagnosed as C4 lesions all turned out to be carcinoma on histopathology. In this study, FNAC and histopathology diagnoses were strongly correlated [r 0.92, p &lt;0.001]. Conclusion: Diagnosis of breast lump based on FNAC should be practiced as there is high correlation with histopathological finding. FNAC should be used as a routine diagnostic procedure due to its cost effectiveness, thus maximizing the availability of effective health care to patients with breast lesions.