Clinicopathological Analysis of Breast Lump in Females

Abstract

Introduction: Breast is a glandular organ which is affected by hormones. Among all the disorders of breast, palpable lump in the breast is the second most common presentation, following pain which is the most common presentation. Being under hormonal control, breast tissue undergoes changes from birth till the end of the reproductive life. The changes in breast of a female are usually associated with inordinate anxiety and apprehension from the patient and her family. As such changes have array of presentations and pathological findings which according to the modern protocol demands a step-wise diagnostic approach involving clinical, radiological and pathological examination. Materials and Methods: This prospective study was conducted from October 2015 to September 2017 on female patients admitted to S.B.K.S. Medical Institute & Research Center, Dhiraj General Hospital, Pipariya, Vadodara. 100 female patients with breast lumps were enrolled in this study. Results and Analysis: Out of the 100 females having breast lumps that were studied, most presented in 5th decade of life, with predominance towards malignant lesions. Majority of the benign lesions were seen in 3& 4th decade while malignant in 5th decade of life. The most common presenting complain was lump in breast associated with pain. Majority of the females had late presentation after onset of symptoms. Majority of the patient were multiparous. Most patients with benign lesions were premenopausal while most with XI malignant were postmenopausal. History of Oral Contraceptive use and that of breast feeding was seen in most females. Approximately half of the females had lumps greater than 2 cms and were hard in consistency. Most common lesion on clinical examination was carcinoma of breast.The most common benign lesion on histopathology examination was fibroadenoma while the most common malignant lesion was invasive ductal carcinoma. Majority of the patients showed up for followup upto 1 year. 5 patients with carcinoma of breast had recuurence of ipsilateral breast on follow-up.1 patient each showed liver, lung and skeletal metastasis on follow-up. Conclusion: Analytical study of clinic-pathological features of 100 female patients having breast lumps showed that there is alarming high incidence of breast cancer out of which most presented with advanced stages at a later age. Benign diseases were common among the younger age group among which fibroadeomas were the most common. Certain findings on clinical examination allowed accurate differentiation between benign and malignant lumps. Risk factors for development of breast cancer showed strong association with our findings. Discrepancies among the findings established between clinical examination and laboratory findings suggest FNAC and histopathological examination are required investigation for the confirmation of the diagnosis.