Article

Fine Needle Aspiration Cytology of Palpable Breast Lump: A Study of 1778 Cases

Authors:
To read the full-text of this research, you can request a copy directly from the author.

Abstract

Background: Breast carcinoma is the most common malignant tumour and the leading cause of death from cancer in women. A large number of patients in Bangladesh have been suffering from breast cancer. Now-a-days, FNAC is being performed as a pre-operative test to evaluate breast lump. FNAC is cost effective and can prevent unnecessary surgery. As FNAC became more reliable in diagnosing malignancy and thereby the use of frozen-section histology had been reduced by about 80%. This study intended to look the frequencies of different lesions in FNAC of palpable breast lump. Methods: FNAC was done in a total of 1778 female patients presented with palpable breast lump along with suspected enlarged axillary lymph node, if any. We assessed the age of the patient, lesion size, site, type of lesion and axillary lymph node metastasis in case of malignancies. Results: Age ranges from 14-86 years with a mean age of 33.6 years. Most of the patients were in 21-30 years age group (38.13%). Among the lesions 508 (28.57%) fibroadenoma, 252 (14.17%) carcinoma, 210 (11.81%) fibrocystic changes, 141 (7.93%) abscess, 116 (6.52%) granulomatous lesion, 113 (6.3%) chronic mastitis were identified. 218 (42.91%) of fibroadenoma and 82 (32.54%) of carcinoma were in the age group 21-30 years and 31-40 years respectively. Mean lesion size was 4.3 ± 2 cm. Site distribution in different cases is almost equal. 116 of carcinoma patient were presented with palpable lymph node and showed metastasis in 26 (10.32%) cases. Conclusion: FNAC serves as a rapid, economical, and reliable tool for the diagnosis of palpable breast lesions because the cytopathological examination of these lesions before operation or treatment, serves as an important diagnostic modality. Fibroadenoma was the commonest lesion in this study. However, malignancy was detected as the second common lesion.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the author.

... | P a g e More than half (52.9%) of cytological report showed fibroaden oma which was the most common lesion of breast lump in this study. This findingagree with studies done in India 2018, 2017, 2016as their result were (56.03%), (55%), (49.25%) respectively (6,11,12).Similar results were also reported by studies done in Sudan 2015, Kenya 2015 and Bangladesh 2013 that fibroadenoma most frequently diagnosed breast lesions (8,7,13).This higher rate in accordance with the facts that fibroadenoma is the most common benign breast mass (2). In this study the second most common cytological lesion of breast lump is malignancy (12.9%)and this could explained by the fact that, in Iraq breast cancer ranks the first among the top ten malignant neoplasms affecting the community; comprising 19.5% of total and 34.3% of female cancers . ...
... In this study the second most common cytological lesion of breast lump is malignancy (12.9%)and this could explained by the fact that, in Iraq breast cancer ranks the first among the top ten malignant neoplasms affecting the community; comprising 19.5% of total and 34.3% of female cancers . [14] Similar results were found in studies done in India 2018, Sudan 2015 and Bangladesh2013 as their reported that fibroadenoma followed by malignancy was the commonestbreast lesions were identified (6,8,13). ...
... This result agree with study done in Sudan 2015 as it shown that most fibroadenoma were reported in individuals younger than 36 years, whereas most malignant conditions were found in individuals 36 years and above (8). Similar result was also reported in study done in Bangladesh 2013 as it shown that fibroadenoma mostly found in the age group (21-30) while majority of malignant cases were found in middle age group (31-50) (13). Our result in accordance with studies done in Iraq 2012, 2019 as their result reported that the peak incidence of malignant conditions was in the 6th decade of life, while the peak incidence of benign conditions was in the 3rd decade, and the mean age of cases with malignant lesions was (50.7 ±12. ...
Article
Full-text available
Abstract Breast lump is defined as any swelling present in the breast. Fine needle aspiration cytology (FNAC) has been considered reliable, rapid and economical method when combined with clinical impression and radiological findings to accurately diagnose palpable breast masses. The aims of this study was to find frequency distribution of various breast lesions on FNAC among sample of Iraqi women with palpable lump and to find association between socio-demographic characteristics and commonest breast lesions. A cross sectional study was conducted in Al Elweiya Teaching Hospital in Baghdad for a period of 5months/2days per week; from first of Augus t till the end of December 2019. The study sample included any female patients with palpable lump on clinical examination visiting the breast cancer screening unit. The total sample size reached to 140 cases. FNAC was performed for every patient included in this study. The results show of the 140 diagnosed breast lesions, 101 (72.1%) were neoplastic and 39 (27.9%) were non-neoplastic. Of the neoplastic breast lesions, 74 (73.3%) were benign while 27 (26.7%) were malignant. Thus, the benign to malignant ratio was (2.7:1).More than half 74 (52.9%) of cytological reports showed fibroadenoma, malignant lesions were found in 18 (12.9%) of reports.All variables showed no significant association with developing fibroadenoma or suspicious lesions except for age.Can be concluded that The commonest lesionin all cases with palpable breast lump in this study was fibroadenoma followed by malignant cytological lesion. Age which shown a significant association with those who had fibroadenoma or suspicious and malignant lesions. This study was shown the need for increase the awareness and health promotion about breast cancer, encourage all women especially those 40 years and above to seek breast clinics for screening mammogram accordingly. Keywords: Breast lump, FNAC, Fibroadenoma
... 12 Majority of benign lesions were common in age group of 21 to 30 years followed by 31 to 40 years. This finding is similar to the study done by Bukhari et al. 12 Rahman et al. 13 Singh A 14 while study done by Khemka A showed slightly higher age group (Table 3). Among total 200 cases, 34 (17 %) cases were reported as malignant lesions presenting most commonly in age group of 41 -50 years, among which 28 (82.4 %) cases were ductal carcinoma (most common). ...
... Among total 200 cases, 34 (17 %) cases were reported as malignant lesions presenting most commonly in age group of 41 -50 years, among which 28 (82.4 %) cases were ductal carcinoma (most common). Rahman et al. 13 and Khemka A reported 14.17 % and 22 % of malignant cases respectively which were close to our study. ...
... Fibroadenoma was the most common benign lesion in this study with a peak incidence between 21 to 40 years followed by fibrocystic change. Similar findings were noted in study of Bukhari et al. 12 while Rahman et al. 13 and Singh A 14 showed fibroadenoma occurring in comparably younger age group. Among malignant lesions, infiltrating ductal carcinoma -not otherwise specified which is similar to study by Rahman et al 13 and Khemka A 9 reported 14.17 % and 22 % of malignant cases respectively which were close to our study. ...
Article
BACKGROUND Breast lump is fairly a common complaint in females for which patient seeks medical advice and becomes anxious about the diagnosis. Quick diagnosis by fineneedle aspiration cytology (FNAC) relieves patient’s anxiety and assists in their preoperative management and overall treatment. This study was conducted to find out the cytomorphological patterns and distribution of breast lesions in various age groups in our institute. METHODS This is a prospective observational study of breast lesions conducted in the Mandya Institute of Medical Sciences, Mandya, for a period of 18 months from January 2016 to June 2017. About 200 cases were studied by cytology and correlated with histopathology wherever biopsy specimens were available, and were stained with haematoxylin and eosin (H & E) and May–Grunwald–Giemsa stains (MGG). Cases were grouped according to the five-tier reporting format for breast lesion (C1 – C5) laid down by National Cancer Institute. RESULTS The spectrum of breast lesions on cytomorphological interpretation was 1 % inadequate / insufficient material (C1), 80 % benign (C2), 1.5 % atypia probably benign (C3), 0.5 % suspicious of malignancy (C4) and 17 % malignant (C5). Out of 200 cases studied, 160 cases were benign lesions, and 34 cases were malignant lesions. Most of the benign lesions belonged to the age group 21 - 30 years followed by 31 - 40 years. Malignant lesions were maximum in the age group of 41 - 50 years. In benign disease, fibroadenoma was the commonest i.e. (31 %) followed by fibrocystic change (22 %), benign epithelial hyperplasia (8.7 %), acute mastitis (3 %), chronic mastitis (2 %), epidermal cyst (1.8 %), subareolar abscess, granulomatous mastitis, galactocele (1 %) and gynaecomastia (8.5 %). In the malignant group, infiltrating ductal carcinoma - not otherwise specified, was the commonest lesion (82.4 %), followed by mucinous carcinoma (8.8 %), papillary carcinoma, medullary carcinoma and metaplastic carcinoma (2.9 %). In this study, the specificity, sensitivity, positive and negative predictive value, and diagnostic accuracy of fine-needle aspiration cytology were 100 %, 90 %, 100 %, 95 %, and 96 %, respectively. CONCLUSIONS FNAC of the breast lump is an easily performed outpatient diagnostic method for determining the nature of the breast mass.
... Overall breast lesions were common in age group of 21-30 years (35.2%). Other studies by Rahman MZ et al (38.13%) [8] Rachana Binyake etal (31.66%) [4] Likhar KS et al [8] and Iyer etal [9] showed similar findings. Benign lesions were most common in the age group of 21 -30 yrs (30%) followed by 31-40 years ( 26.5%) .Malignant lesions were more common in the age group of 41 -50 years (35.2%), ...
... Overall breast lesions were common in age group of 21-30 years (35.2%). Other studies by Rahman MZ et al (38.13%) [8] Rachana Binyake etal (31.66%) [4] Likhar KS et al [8] and Iyer etal [9] showed similar findings. Benign lesions were most common in the age group of 21 -30 yrs (30%) followed by 31-40 years ( 26.5%) .Malignant lesions were more common in the age group of 41 -50 years (35.2%), ...
... Most common malignant lesion is duct cell carcinoma (94.2%) and it was common in the age group of 41 -50 years. Similar findings were seen in studies done by Rahman MZ et al [8] Pradhan etal [12] jarwani PB etal [13] Ghosh A et al [13] and Rachana Binyake et al [4] .Two cases showed duct cell carcinoma with metastasis to axillary lymphnodes. Distribution of lesion among males: In males maximium number of patients were in the age group of 21 -30 years. ...
Article
Full-text available
Background: Various diagnostic techniques are developed for evaluation of breast lesions. Breast lumps are a common presentation in the outpatient department due to increasing awareness of breast cancers. Distinguishing non-neoplastic from neoplastic breast lesions is important for definitive treatment. Fine needle aspiration cytology is an easy, cost effective and rapid way of diagnosing palpable breast lesions. Methods: This is a one year study between March 2018 to March 2019.Fine needle aspiration cytology was performed on 153 patients with palpable breast lesions which included 13 males and 140 females. Results: Most of the patients with breast lump were in the age group of 21-30 years. Benign lesions (56.2%) are more common than malignant lesions (11.76%). Among benign lesions fibroadenoma is commonest. Malignancies are more common in elderly age group above 40 years, among these duct cell carcinomas accounts to 94.4%. Conclusion: Fine needle aspiration cytology is simple, easy and cost effective procedure for diagnosing and categorizing palpable breast lesions. Benign breast lesions are more in younger age group and malignancies in elder age group.
... Overall breast lesions were common in age group of 21-30 years (35.2%). Other studies by Rahman MZ et al (38.13%) [8] Rachana Binyake etal (31.66%) [4] Likhar KS et al [8] and Iyer etal [9] showed similar findings. Benign lesions were most common in the age group of 21 -30 yrs (30%) followed by 31-40 years ( 26.5%) .Malignant lesions were more common in the age group of 41 -50 years (35.2%), ...
... Overall breast lesions were common in age group of 21-30 years (35.2%). Other studies by Rahman MZ et al (38.13%) [8] Rachana Binyake etal (31.66%) [4] Likhar KS et al [8] and Iyer etal [9] showed similar findings. Benign lesions were most common in the age group of 21 -30 yrs (30%) followed by 31-40 years ( 26.5%) .Malignant lesions were more common in the age group of 41 -50 years (35.2%), ...
... Most common malignant lesion is duct cell carcinoma (94.2%) and it was common in the age group of 41 -50 years. Similar findings were seen in studies done by Rahman MZ et al [8] Pradhan etal [12] jarwani PB etal [13] Ghosh A et al [13] and Rachana Binyake et al [4] .Two cases showed duct cell carcinoma with metastasis to axillary lymphnodes. Distribution of lesion among males: In males maximium number of patients were in the age group of 21 -30 years. ...
... Fine needle aspiration cytology (FNAC) has become a diagnostic tool to assess the nature of palpable breast lesions. [1,2] It forms an important part of the pathological assessment since it is easy, relatively painless, quick and a cost effective technique. It also helps in planning of treatment of breast lump. ...
... Accuracy can be improved by multiple sampling from different angles and by using ultrasound guidance in very small lumps. [1,2,3] The present study was undertaken to study the Cytomorphological spectrum of breast lesions and to determine the accuracy & efficacy of FNAC in the diagnosis of various breast lesions. ...
... years. [1,2,3,4,5,8,9,11,12,13] In the present study, 90 cases were positive for malignancy (17.5%). 04 cases (0.78%) were categorized into Atypical Ductal Hyperplasia (ADH)/Ductal Carcinoma in Situ (DCIS) and 05 cases were classified as suspicious of malignancy (0.97%). ...
Article
Full-text available
AIM: The present study was undertaken to study the Cytomorphological spectrum of breast lesions and to determine the efficacy of FNAC in the diagnosis of various breast lesions. MATERIALS AND METHOD S: A total of 512 cases were included in the study. The period of study was from January 2014 to December 2014. RESULTS: The patient’s age group ranged from 16 to 87 years with a mean age of 34.54 years. There were 6 male patients and 506 female patients. Among the category of lesions, the highest incidence recorded wa s of fibroadenoma (184=35.9%) that was followed by carcinoma (90=17.5%) and then by benign breast disease and fibrocystic disease with 79 and 48 cases respectively. Among carcinoma cases, 88 were classified as ductal carcinomas and 02 as mucinous carcinoma s. Inflammatory lesions accounted for 65 cases (12.7%), which included 40 cases of abscess, 20 cases of granulomatous mastitis and 05 cases of chronic mastitis. 04 cases were categorized into Atypical Ductal Hyperplasia (ADH)/Ductal Carcinoma in Situ (DCIS ) and 05 cases were classified as suspicious of malignancy. 38 of 90 cases classified as malignant showed enlarged and palpable axillary lymph nodes. 09 (10%) of these cases showed metastatic deposits . CONCLUSION: FNAC is a relatively simple procedure with good patient acceptance and low morbidity. It is an accurate, safe and repeatable procedure in the diagnosis of various breast lesions – both malignant and non - malignant.
... Our finding is concordant with Jayaram G et al [4] and PB Jarwani et al [5] who also found inadequate samples to be 7.43% and 4.5% respectively. In our study, maximum number of cases was in 20-29 years which is in concordance with the result of the studies by Modi P et al, al [6] Singh A et al, [7] Chaudhury S et al, [8] Likhar KS et al, [9] Thakkar B et al. [10] Maximum number of benign cases was in the age group of 20-29 years which is near similar to the findings of Modi P et al, [6] Likhar KS et al, [9] Rahman MZ et al [11] and Thakkar B et al. [10] Maximum number of malignant cases fell between 50-59 years. Our finding are in concordance with studies of A Singh et al, [7] Bukhari MH et al, [12] Chaudhury S et al, [8] Likhar KS et al [9] while slightly lower age group of 41-50yrs was noted by Thakkar B et al. [10] In our study, 83% cases were benign which is close to the finding of Chaudhury S et al [8] (80.77%) while Modi P et al, [6] Bukhari MH et al, [12] Thakkar B et al [10] found lower percentage of benign cases i.e. 72%, 60%, 54.16% respectively. ...
... Our study did not include these categories. In our study 17% cases were malignant which is near similar to the findings of Modi P et al, [6] Chaudhury S et al, [8] Rahman MZ et al [11] as their reported rates of malignancy were 16.7%, 19.23% and 14.17% respectively. ...
... Fibroadenoma (57.4%) was the major cause of the breast lump in this study which is similar to the findings of Nagao T et al [3] , Modi P et al [6] , Bukhari MH et al [12] , Rahman MZ et al [11] . ...
Article
Background: - Myoepithelial cells of the mammary gland are considered to be a key in distinguishing benign from malignant disease in fine-needle aspiration cytology (FNAC). p63 decorates the nuclei of myoepithelial cells. In view of this, present study was undertaken to study the difference in number of myoepitheal cells in various breast lesions using anti p63 immunocytochemistry. Methods: This study was conducted on 50 patients presenting with breast lump. FNA was done, smears prepared were stained with May Grunwald Giemsa and subjected to immunocytochemistry for p63. MGG stained smears were subjected to quantitative estimation of myoepithelial cells per 1000 ductal cells. Percentage of cell clusters showing p63 positive cells were noted. Only the nuclear immunoreactivity for p63 was considered specific. Result: Maximum number of cases (26) were in 20 – 29 years age group (55.3%).The mean number of myoepithelial cells in the benign lesions was 196.8 while ductal carcinoma had a mean of 5.8.The difference between the mean of myoepithelial cells/1000 ductal cells was found to be statistically significant (t- value 4.51 and p-value .000048). The difference in p63 immunostaining between benign and malignant lesions was also found to be statistically significant (for positivity of p63 at 0% and > 75% p value <0.001). Conclusion: We hereby conclude that myoepithelial cells are a key to distinguish benign from malignant lesions in FNAC. Their sensitivity is increased by staining with p-63 antibody. We also conclude that presence of more than 74% positive cell clusters is strongly suggestive of benign lesions. DOI: 10.21276/apalm.2017.1092
... Diseases of breast constitute a significant proportion of surgical cases in both developed and developing countries [2]. Breast lump is a cause of concern with associated cosmetic consideration, social stigma and hesitance in consultation [3]. In 1984, Wanebo et al. suggested Fine Needle Aspiration in place of open surgical biopsy for the diagnosis of breast cancer [2]. ...
... Spectrum of lesions of breast is wide ranging from non-neoplastic lesions to high grade carcinoma. Most of the non neoplastic lesions of breast presenting as breast lump appear neoplastic, making clinical diagnosis difficult [3]. FNAB is an increasingly popular technique utilized in the diagnosis of palpable breast masses owing to its distinct advantage of being sensitive and specific, expedient, economical and safe [2]. ...
... The study subject's age ranged from 11 to 84 years with mean age of 32.03 ± 14.25 years. The age range in our study was in accord to the other studies, ranging from 14 to 86 years but was higher than the studies carried out in Nepal and Pakistan varying from 17-56 years to 16-70 years [3,5]. Increased life expectancy of the study population could be a reason for higher age range of our study subjects as compared to subjects from Nepal and Pakistan. ...
Article
Full-text available
Background Breast cancer being the most common cause of cancer death among women, this study was planned to find out the effectiveness of FNAB (fine needle aspiration biopsy) as screening and diagnostic tool in resource poor setting lacking sophisticated imaging modalities. Methodology A retrospective study comprising two year records of 588 patients undergone FNAB and their histopathological correlation was used to derive the epidemiology of palpable breast lumps, spectrum of lesions and efficacy of FNAB in our hospital set up. Results Study comprises of 588 cases of which 538 (92.22%) were female and 50 (8.57%; P < 0.0001) male. Male to female ratio was found to be 1:10.76. The mean age of presentation was 37.8 ± 20.92 years for male and 31.5 ± 13.32 years (P = 0.04) for female. Among the various cytological findings fibroadenoma was found to be present in 304 (57.46%) female while male were flourishing with 41 (87.23%) gynecomastic. Out of 588 cases cytological spectrum defines benign, malignant, atypical, suspicious of malignancy and unsatisfactory as 464 (78.91%), 76 (12.92%), 28 (4.76%) and 12 (2.04%) respectively. The sampling adequacy, sensitivity, specificity, positive predictive and negative predictive value was found to be 97.95%, 100%, 87.80%, 79.16% and 100% respectively. Discussion and conclusion Present study demands the further exploration of factors influencing the disparity in delayed reporting among male and female. Statistical figure of comparable adequacy, sensitivity, specificity, positive predictive and negative predictive value to other studies suggest that FNAB could be used as a good screening and diagnostic tool for breast lesions in resource poor settings which lacks sophisticated imaging techniques. Keywords Breast cancer; Fine needle aspiration biopsy; Screening; India
... Diseases of breast constitute a significant proportion of surgical cases in both developed and developing countries [2]. Breast lump is a cause of concern with associated cosmetic consideration, social stigma and hesitance in consultation [3]. In 1984, Wanebo et al. suggested Fine Needle Aspiration in place of open surgical biopsy for the diagnosis of breast cancer [2]. ...
... Spectrum of lesions of breast is wide ranging from non-neoplastic lesions to high grade carcinoma. Most of the non neoplastic lesions of breast presenting as breast lump appear neoplastic, making clinical diagnosis difficult [3]. FNAB is an increasingly popular technique utilized in the diagnosis of palpable breast masses owing to its distinct advantage of being sensitive and specific, expedient, economical and safe [2]. ...
... The study subject's age ranged from 11 to 84 years with mean age of 32.03 ± 14.25 years. The age range in our study was in accord to the other studies, ranging from 14 to 86 years but was higher than the studies carried out in Nepal and Pakistan varying from 17-56 years to 16-70 years [3,5]. Increased life expectancy of the study population could be a reason for higher age range of our study subjects as compared to subjects from Nepal and Pakistan. ...
Article
Background Breast cancer being the most common cause of cancer death among women, this study was planned to find out the effectiveness of FNAB (fine needle aspiration biopsy) as screening and diagnostic tool in resource poor setting lacking sophisticated imaging modalities. Methodology A retrospective study comprising two year records of 588 patients undergone FNAB and their histopathological correlation was used to derive the epidemiology of palpable breast lumps, spectrum of lesions and efficacy of FNAB in our hospital set up. Results Study comprises of 588 cases of which 538 (92.22%) were female and 50 (8.57%; P < 0.0001) male. Male to female ratio was found to be 1:10.76. The mean age of presentation was 37.8 ± 20.92 years for male and 31.5 ± 13.32 years (P = 0.04) for female. Among the various cytological findings fibroadenoma was found to be present in 304(57.46%) female while male were flourishing with 41 (87.23%) gynecomastic. Out of 588 cases cytological spectrum defines benign, malignant, atypical, suspicious of malignancy and unsatisfactory as 464(78.91%), 76(12.92%), 28(4.76%) and 12(2.04%) respectively. The sampling adequacy, sensitivity, specificity, positive predictive and negative predictive value was found to be 97.95%, 100%, 87.80%, 79.16% and 100% respectively. Discussion and conclusion Present study demands the further exploration of factors influencing the disparity in delayed reporting among male and female. Statistical figure of comparable adequacy, sensitivity, specificity, positive predictive and negative predictive value to other studies suggest that FNAB could be used as a good screening and diagnostic tool for breast lesions in resource poor settings which lacks sophisticated imaging techniques.
... In our study fibroadenoma is the most common benign lesion which correlates with the other studies. 23,24,25 The incidence of fibrocystic change in our study is 16.66 and its incidence is very variable in different series. 24,25,26 It is important to distinguish benign breast lesions from breast carcinoma because the majority of benign lesions are not associated with an increased risk for subsequent breast cancer, hence unnecessary surgical procedures can be avoided. ...
... 23,24,25 The incidence of fibrocystic change in our study is 16.66 and its incidence is very variable in different series. 24,25,26 It is important to distinguish benign breast lesions from breast carcinoma because the majority of benign lesions are not associated with an increased risk for subsequent breast cancer, hence unnecessary surgical procedures can be avoided. It is also important to distinguish benign lesions from in-situ and invasive breast cancer and to assess a patient's risk of developing carcinoma breast, so that the most appropriate treatment modality for each case can be established. ...
... In our study, 12.12% cases were reported as carcinoma on FNAC, which is comparable with other studies. 24,27,28,29 In our study, there were 13.63% cases of benign inflammatory lesions and majority of these were acute mastitis and breast abscess. Incidence of inflammatory lesions also vary in different series. ...
... Diet has been also found to play an important role in the etiology of breast cancer. There is increasing awareness with associated anxiety and stress among women, who perceive every symptom in breast as cancer, compelling them to seek medical advice 3 . It is sometimes difficult to determine whether a suspicious lump is benign or malignant simply from clinical assessment 4 . ...
Article
Full-text available
Background: Diagnosis of breast pathology is very important for the management of the patients. Objective: The purpose of the present study was to compare the fine needle aspiration cytology (FNAC) and trucut biopsy for the diagnosis of breast pathology. Methodology: This analytical cross-sectional study was conducted in the Department of Surgery at Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh from 1 April to 31 October 2020 for a period of six months. All the women who were attended at the OPD of the Department of Surgery with the different complaints of breast at any age were selected as study population. The different disease profiles were recorded in the data sheet. Result: A total number of 200 patients were recruited for this study. The mean age with standard deviation was 33.85±7.969 years. The male and female ratio was 1:19. Breast pathology was found in equal in left and right side which was 100(50.0%) cases in each. The central zone was the most common area which was 90(45.0%) cases. Most of the breast pathology was firm which was 170(85.0%) cases. The comparison of FNAC and tru-cut biopsy was done. Fibroadenoma was found in 50(100.0%) cases in FNAC; but in tru-cut biopsy 10(20.0%) case was fibroadenoma; invasive ductal carcinoma was in 30(60.0%) cases and the rest of 10(20.0%) case was Phylloides tumor. In FNAC 1 case was diagnosed as gynaecomatia which was diagnosed as intradermal papilloma in tru-cut biopsy. The difference between the FNAC and tru-cut biopsy for the detection of different pathology of breast was statistically significant (p=0.000). Conclusion: In conclusion there is a significant difference between FNAC and tru-cut biopsy for the detection of breast pathology. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 33-37
... 2 As it is the one of the leading causes of cancer death in women, the major concern of the surgeon and the responsibility of the surgical pathologist lies in the ability to differentiate a benign lesion from a malignant one. [3][4] Women should be educated and should be aware of the symptoms of Breast cancer. Screening can be done stringently to detect the cancer at the earliest. ...
Article
Full-text available
Background: Breast cancer is one of the most common malignancies in women worldwide (22%) and India ranks the second after cervical cancer. The diagnostic accuracy of FNAC increases to 99% when it is combined with clinical and radiological examination. In this study, authors plan to correlate the cytological findings with histopathological examinations for breast lesions and determine the accuracy of fine needle aspiration cytology in the diagnosis of breast lesions.Methods: It is a retrospective study carried out in the Department of Pathology at a Tertiary Care Hospital. All the FNAC results of breast lesions during the one year period were collected. Gauge needle maximum of 3 passes were made and the slides were fixed in 70-80% alcohol and stained with routine haematoxylin and eosin stain.Results: Among 200 patients, 197 were females and 3 were males. Benign breast lesions were found in 158 cases; among which fibroadenoma was the commonest lesion. Malignancy was observed in 25 cases. Two cases of phyllodes tumour were incorrectly reported as fibroadenoma on cytology. Of 12 cases which were diagnosed to have atypical lesions, 4 cases were papillary neoplasm, and 8 cases were atypical ductal hyperplasia.Conclusions: This study concludes that breast FNAC is a reliable, easy, cheap and effective procedure for the diagnosis. It reduces the need of core needle biopsies and very well correlated with histopathological examination. FNAC differentiates non neoplastic from the neoplastic by which it reduces the patient’s anxiety and helps the surgeons in planning the mode of treatment.
... A study from Bangladesh found it to be 44.3 years. 30 In India, a number of hospital-based studies found mean age to be 44.2 years to 49.6 years. 31 Mean age in Pakistani studies ranged from 45 to 50 years. ...
Article
Full-text available
Background: Spectrum of female breast diseases is manifold and includes various non-neoplastic and neoplastic conditions. This study focused on the clinico-pathological profile of several breast diseases, including fibrocystic change, fibroadenoma and breast carcinoma. Methods: This cross sectional analytic observational study included Fine Needle Aspiration Cytology cases of female breast diseases diagnosed over three years from 2011 to 2014 in Chitwan Medical College Teaching hospital in Central Nepal. Univariate analysis was carried out to find out age group-wise proportion of the diseases in relation to five cytologic categories and various cytomorphologic diagnoses. Independent samples t-test was used to find out the significance of difference between mean age of benign and malignant breast diseases. Results: The proportion of benign, suspicious for malignancy and malignant breast diseases was 90.4 %, 0.8% and 8.8 % respectively. The mean age of patients at diagnosis for benign diseases and malignant disease was 31.7± 10.4 years and 49.2 ± 12.0 years respectively. t-test showed difference in mean age between benign and malignant diseases to be statistically significant (t=8.79, p= <0.001). Fibrocystic change and fibroadenoma were the most common breast disease overall and the most common neoplasm respectively. 58.1 %, 25.9 % and 6.5 % of all carcinoma cases in this study were found below 50, below 40 and below 30 years of age respectively. Conclusions: Fibrocystic change and fibroadenoma are most common disease of breast and most common neoplasm of breast respectively. Breast cancer occurs in younger women in Nepal in comparison to women in developed countries. Therefore, breast cancer prevention programs in Nepal should target young women also. Keywords: Breast lump, Fibrocystic disease, Fibroadenoma, Breast cancer, Prevention, Nepal
... Lump in breast, whether benign or malignant is the main cause of anxiety to the patient and her family members. Breast carcinoma is the most common malignant neoplasm and the leading cause of death from cancer in women, with more than one million cases occurring worldwide annually 1,2 . Though histopathological diagnosis is universally accepted confirmatory mode of diagnosis and follow up, fine needle aspiration cytology (FNAC) of breast lumps is an important part of triple assessment (Clinical examination, imaging, and FNAC) of palpable breast lumps 3 . ...
Article
Full-text available
p> 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 College V olume, 09, Number 2, July December 2016, Page: 38-42
... [6] Early screening and diagnosis of breast lesions and categorization into different groups of breast pathology can be helpful in accurate management of breast lesions. [7] FNAC has some pitfalls in the diagnosis of fibrocystic diseases, adenosis and epithelial hyperplasia with/without atypia, apocrine metaplasia and papilloma which may have to be correlated with imaging studies to rule out malignancy. [4] However, FNAC in the context of a rapid assessment of breast lesions allows the same day diagnosis and early treatment of breast cancer, with the immediate reassurance and discharge of those cases with benign disease. ...
... [12][13][14] In the present study, 32.4% cases were malignant which is much higher than the findings of Modi P et al, Chaudhary S et al and Rahman MZ et al, as their results were 16.7%, 19.23% and 14.7% respectively. 12,15,16 Fibroadenoma accounted for 49.3% of all the breast lumps in our study. Our finding was in agreement with most of the available literature on benign breast lumps, where the frequency of fibroadenoma ranged from 46.6%-55.6%. ...
Article
Full-text available
Background: Breast lump among females, is a fairly common complaint. Breast lump have a variety of etiologies ranging from inflammatory to benign to malignant lesions. Myoepithelial markers are useful in helping to distinguish invasive carcinoma from benign proliferations with a similar morphological appearance, benign proliferative lesions and most pre-invasive lesions with an intact myoepithelium. Invasive carcinomas lack the myoepithelial cell layer that normally surrounds benign breast glands. p63 antibody is a myoepithelial cell marker that selectively stains nuclei. Also, it is negative in stromal, myofibroblastic and adipocytic cells. This makes p63 more specific and superior to other myoepithelial markers.Methods: The present study was done on a total of 151 cases of breast diseases, received in the form of core biopsy, tru cut biopsy, lumpectomy, and mastectomy specimens. Clinical history and examination findings of the patients were collected in all the cases. All specimens were routinely processed and stained with haematoxylin and Eosin (H and E) stain and only 50 cases were subjected to immunohistochemical staining for p63.Results: Out of total 151 cases, 09 were inadequate for evaluation, 96 cases benign and 46 malignant. In benign category, fibroadenoma was most common and infiltrating ductal carcinoma (NOS) was the most common in malignant category. Mean size of benign tumors was found to be less than that of malignant tumors. All malignant cases were negative for p63 expression. In the benign category, 88.6% cases showed positive expression for p63 while 11.4% were negative. Among the benign category, non-proliferative lesions were continuous positive, proliferative showed discontinuous positivity for p63.Conclusions: Myoepithelial markers are useful in helping to distinguish invasive carcinoma from benign proliferations with a similar morphological appearance, benign proliferative lesions and most pre-invasive lesions with an intact myoepithelium. Invasive carcinomas lack the myoepithelial cell layer while in the benign category, non-proliferative lesions are continuous positive, proliferative lesions show discontinuous positivity for p63.
... Impact Factor (SJIF): 6.379 Index Copernicus Value: 79.54 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v6i10.125 component of triple test which in addition to FNAC, includes clinical examination and mammography and is a standard approach to the investigation of palpable breast lumps [5] . Histopathological examination is an universally accepted method of diagnosis and follow up; FNAC can reduce the number of open biopsies which are cumbersome, expensive and time consuming [6] and can provide a diagnosis with only 10-30% of the cost of surgical biopsy [7] . If the smears are satisfactory & adequate and cytological criteria are fulfilled, most of the cases can be diagnosed confidently. ...
... Because of existing social circumstances female patients are hesitant to be examined by the clinicians for breast lump, the patients are reporting in advanced stage of malignancy. 3 The role of non-operative techniques in definitive diagnosis of malignancy is to enable rapid referral for treatment, ideally in one operative procedure. 4 Fine needle aspiration cytology (FNAC) of the breast, as part of the triple approach to the diagnoses of palpable breast lesions, has become a valuable pre-operative tool. ...
Article
Full-text available
Background: One of the most common medical problems, women face today, is a lump in the breast. These lumps may range from simple inflammatory to malignant. In case of carcinoma, early and accurate diagnosis can save the patient from metastases thus reducing mortality and morbidity. The aim of the present study is to see the spectrum of lesion in breast lump specimens in Ibn e Sina Hospital, Multan Medical and Dental College, Multan over a period of ten years.Methods: This retrospective study was carried out in the Department of Pathology, Multan Medical and Dental College Multan, Pakistan. Data were gathered from the archives of Pathology laboratory, comprising of years 2007 t0 2017, after approval from Institutional Ethical Review Committee. All the patients presented with complaint of any kind of swelling of breast were included in this study. All the demographic and clinical details of the patients were collected on proforma. Fine needle aspiration technique was used to take sample from the suspected lesional area. Descriptive statistics was used to analyze the data.Results: A total of 2039 patients were presented with complaint of lump/swelling in their breast unilaterally or bilaterally. There were 628 (30.8%) benign lesions, 872 (42.8) malignant lesions, 229 cases with atypical cells. Mastitis/inflammatory lesions were seen in 167 (8.2%) cases and tuberculous granulomas were observed in 83 (4.07%) cases. Twenty cases were of miscellaneous types including lipoma, phylloda, simple cysts etc.Conclusions: Findings of present study show that majority of breast lumps were malignant, benign, inflammatory and tuberculous respectively.
... The age range of 123 patients was 12 to 65 years with maximum number of patients were in 21-30 years group, 39 (31.7%). Rahman and Islam in their study showed highest number of patients (38.13%) were in 21-30 years age group which is similar to our study 12 . Study done by Ramraje et al 13 . ...
Article
Background: Diseases of the breast constitute a significant proportion of surgical cases and frequently, the need arises to distinguish benign from malignant lesions prior to definitive treatment. So far, Frozen Section (FS) is the standard technique with high level of validity. However, intraoperative scrape cytology can be adopted when special facilities of FS are not available. Methods: This study designed with the aim to evaluate the value of Intraoperative Scrape Cytology (IOSC) in providing rapid and accurate diagnosis for breast lump and to compare its diagnostic yield with that of paraffin sections. This cross sectional descriptive study was carried out in the Department of Pathology, Chittagong Medical College in collaboration with Department of Surgery of this institution from October 2013 to September 2014. The study conducted on 123 patients with breast lumps who underwent operative treatment. Scrapings were taken from each specimen before formalin fixation and stained by rapid Papanicolaou staining. In each case their accuracy was compared to histopathological diagnosis. Statistical analysis done employing c2 test. Results: Out of 123 cases studied, 122 could be correctly differentiated into benign and malignant tumors with an accuracy rate of 99.19%. Conclusion: Intraoperative Scrape Cytology (IOSC) is a simple, accurate, rapid and cost-effective diagnostic tool, not requiring specific instruments in contrast to frozen section, can be used peroperatively for both diagnosis and management of breast lump. Chatt Maa Shi Hosp Med Coll J; Vol.17 (2); Jul 2018; Page 26-30
... Because of existing social circumstances female patients are hesitant to be examined by the clinicians for breast lump, the patients are reporting in advanced stage of malignancy. 3 The role of non-operative techniques in definitive diagnosis of malignancy is to enable rapid referral for treatment, ideally in one operative procedure. 4 Fine needle aspiration cytology (FNAC) of the breast, as part of the triple approach to the diagnoses of palpable breast lesions, has become a valuable pre-operative tool. ...
... It has been emphasized in the past that vast majority of the lesions in breast are benign. [14,15] Fibroadenoma was the most frequently (N = 83) diagnosed lesion on FNA with maximum (N =76) patients between 17-30 years. Definitive FNA diagnosis was based on diagnostic triad of cellular smears with bimodal pattern, numerous single bare bipolar nuclei and fragments of fibromyxoid stroma. ...
... In the current study, right breast was more commonly involved then left breast, similar results were observed in other studies. 3,9,11,12 However, some studies involvement of the left breast was more than of the right. 13,14,15 In the present study, incidence of benign lesions which accounts for 268/434 cases (61.7%) predominated over inflammatory lesions (23.1%) and malignant lesions ( In the current study, the most common cytologically diagnosed inflammatory/infectious lesion was acute/subacute mastitis (11.5%) and benign lesion was fibroadenoma (32.7%) which correlates with the finding of other studies. ...
... cases were ductal carcinoma (most common). Rahman et al 13 One case was reported as medullary carcinoma by FNAC and histopathology. This is similar to study done by Kanchana P. V. N et al who had reported 2 cases of medullary carcinoma. ...
... Out of 192 patients, 81.77% (N = 157) had benign breast lumps and 18.22% (N = 35) had malignant breast lumps. It has been emphasized in the past that vast majority of the lesions in breast are benign [13,14]. Some of these lesions simulate carcinoma clinically, radiologically and microscopically. ...
... 15 Malignant neoplasms accounted only (n = 369, 13.73 %) numbers in our study, which is in contrast to the study done by Sing A et al 2011. 22 23 reported that infiltrating duct carcinoma of breast is the commonest breast malignancy and found mostly in the age group of 41 -60 years age. The present study also showed that infiltrating duct carcinoma was the most common breast malignancy (n=341, 92.41%) and encountered mostly in the age group of 41-60 years of age (n=270; 79.18%) in our study. ...
Article
Full-text available
BACKGROUND The breast is composed of both specialised epithelial cells and stroma. Both benign and malignant lesions can occur in the breast as a palpable lump. Fine needle aspiration cytology (FNAC) is a rapid, easy to perform, minimally invasive and low cost first line high-diagnostic accuracy test for cytopathological evaluation of palpable breast lump with minimum complications. METHODS The study was carried out to evaluate the cytopathological patterns of 2706 palpable breast lumps by fine needle aspiration (FNA) procedure and cytohistopathological correlation of the available biopsied palpable breast lumps of the study in the Pathology department of Tezpur Medical College and Hospital, Assam, for a period of three years from July 01, 2016 to June 30, 2019. RESULTS Out of 2706 palpable breast lumps in the study, FNA smears of 19 (0.70 %) were inadequate for cytopathological reporting. Out of the remaining 2687 palpable breast lumps where FNA was adequate for cytopathological reporting, female patients (n = 2594) comprised 96.54 % and male patients (n = 93) comprised 3.46 % with a male and female ratio of 1:27.9. Out of the 2687 palpable breast lumps, 2318 were benign breast diseases (86.27 %) and 369 were malignant neoplasms (13.73 %), with a benign and malignant ratio of 6.28:1. Out of the benign breast lumps, fibroadenoma breast was seen in 1228 (52.98 %) and of the malignant neoplasms, infiltrating duct carcinoma was seen in 341 (92.41 %). Cytohistopathological correlation showed 98.70 % sensitivity, 99.38 % specificity, 99.35 % positive predictive value, 98.76 % negative predictive value, and 99.04 % diagnostic accuracy. CONCLUSIONS FNAC has high sensitivity and specificity in cytopathological diagnosis of palpable breast lumps. Based on the accurate cytopathological diagnosis of the palpable breast lumps, patients with palpable breast lumps can be given adequate treatment.
... It has been emphasized in the past that vast majority of the lesions in breast are benign. [1,[16][17][18][19][20] Fibroadenoma was the most frequently (N = 389) diagnosed lesion on FNA with maximum (N = 277) patients between 17-30 years. Multiple fibroadenomas were seen in 11.56% (N = 45) patients. ...
Article
Full-text available
Breast lumps constitute a significant proportion of surgical cases in women of both developed and developing countries. The aim of this study is to look the frequency distribution of various breast lesions on fine needle aspiration (FNA). The 902 patients who presented with palpable breast lump, irrespective of age and sex were included in the study. Frequency distribution of various breast lesions with respect to age and sex was studied. Cytology grading in breast carcinoma was correlated in 69 cases with histology grading. The majority (N = 871) of patients were females with maximum (N = 566) patients between second and third decade. The 773 patients had benign breast lesions and maximum (N = 341) patients were in the second decade. Fibroadenoma was the commonest benign lesion followed by fibrocystic change and mastitis. Out of 119 malignant breast lesions, 31.93% [N = 38] were between 41-50 years of age, 28.57% [N = 34] in 51-60 years and 22.68% [N = 27] in between 31-40 years of age. Out of 119 malignant breast lumps and majority were infiltrating ductal carcinoma (N = 108). Cytology grading correlated maximum with histology grade in Grade I followed by Grade II and Grade III. With experienced hands, FNA is safe, cost effective and a reliable technique for preoperative evaluation of palpable breast lumps. FNA features are more informative when combined with physical and radiology findings (Triple test). Fibroadenoma, fibrocystic change and mastitis form the major bulk of benign breast lesions. Epithelioid cells when seen in inflammatory breast FNA smears, tuberculosis must be ruled out. In India, breast carcinoma arises in younger patients as compared to western countries. Grading of breast carcinomas must be done on FNA smears for selecting neoadjuvent therapy. Clinical breast examination and mammography screening in females should be encouraged in developing countries from the third decade onwards for early detection of breast carcinoma.
Article
Full-text available
Breast cancer is the most common malignant tumor and is a leading cause of death worldwide. This study was planned to find out the frequencies of various types of lesions from palpable breasts of female patients through fine needle aspiration cytology. This retrospective study was carried out during December 2017 to May 2018 on 100 female patients presenting with palpable breast mass at University Medical Complex & Research Center, Sargodha, Pakistan. Following written informed consent from patients, a detailed history, patient age, and clinical examination were recorded. The fine needle aspiration cytology was performed and aspirates were processed following the standard methods for cytopathological examination. The cases were grouped according to the five tier reporting format for breast lesion (C1–C5) laid down by the International Academy of Cytologists (IAC) in 2016. The spectrum of breast lesions on cytomorphological interpretation was 54% benign (C2), 2% atypia/suspicious probably benign (C3), 3% suspicious probably malignant (C4) and 41% malignant (C5). Inadequate/insufficient material (C1) was not included in the study. In this study, the specificity, sensitivity, negative and positive predictive value, and diagnostic accuracy of fine needle aspiration cytology were 100%, 91.11%, 98.18%, 100%, and 98.96%, respectively. In benign lesions, maximum cases were of fibroadenoma (24%) followed by fibrocystic disease (4%), lipoma (3%) while benign phyllodes tumor and galactocele were only 1% each. Breast mass was the chief presenting complaint. Breast cancer was commonest among all the morphological patterns of breast lesions followed by fibroadenoma. This study supports that cytological examination using fine needle aspiration cytology is an economical, rapid, easy and valuable diagnostic tool.
Article
Full-text available
Objective: To determine the histopathologic correlation of fine needle aspiration cytology FNAC of breast masses seen in the department of histopathology of the Federal Medical Center Owo, Southwestern Nigeria. Design: This is a 5-year retrospective study of breast lumps seen at Department of Histopathology, Federal Medical Centre Owo, a tertiary health care facility in Southwestern Nigeria between January 1 2010 and December 31 2014. Participants: All patients who had Fine Needle Aspiration Cytology of Breast lumps with subsequent histological confirmation over this period were included in the study. Results: In the five years under review (2010-2014), a total of 289 FNAC of breast lumps were done. The aspirates were obtained from 275 (95.2%) females and 14 (4.8%) males. There were 161 cases of FNAC with corresponding tissue for histological correlation giving a biopsy rate of 55.7%. The sensitivity of FNAC in determining the final histologic diagnosis was found to be 99.4% while the specificity was 100%. FNAC was able to determine final histologic diagnosis conclusively in 86.3% of cases. Conclusion: We therefore concluded that FNAC is a reliable diagnostic tool of breast lumps in our centre. Being a fast and cheap diagnostic tool as highlighted by previous studies, we advocate that clinicians should continue to embrace this diagnostic technique in the surgical management of breast lumps. Funding: This study was entirely funded by the authors.
Article
Breast cancer is the most common malignant tumor and is a leading cause of death worldwide. This study was planned to find out the frequencies of various types of lesions from palpable breasts of female patients through fine needle aspiration cytology. This retrospective study was carried out during December 2017 to May 2018 on 100 female patients presenting with palpable breast mass at University Medical Complex & Research Center, Sargodha, Pakistan. Following written informed consent from patients, a detailed history, patient age, and clinical examination were recorded. The fine needle aspiration cytology was performed and aspirates were processed following the standard methods for cytopathological examination. The cases were grouped according to the five tier reporting format for breast lesion (C1–C5) laid down by the International Academy of Cytologists (IAC) in 2016. The spectrum of breast lesions on cytomorphological interpretation was 54% benign (C2), 2% atypia/suspicious probably benign (C3), 3% suspicious probably malignant (C4) and 41% malignant (C5). Inadequate/insufficient material (C1) was not included in the study. In this study, the specificity, sensitivity, negative and positive predictive value, and diagnostic accuracy of fine needle aspiration cytology were 100%, 91.11%, 98.18%, 100%, and 98.96%, respectively. In benign lesions, maximum cases were of fibroadenoma (24%) followed by fibrocystic disease (4%), lipoma (3%) while benign phyllodes tumor and galactocele were only 1% each. Breast mass was the chief presenting complaint. Breast cancer was commonest among all the morphological patterns of breast lesions followed by fibroadenoma. This study supports that cytological examination using fine needle aspiration cytology is an economical, rapid, easy and valuable diagnostic tool.
Article
Ovarian carcinosarcoma cancer is the most lethal form of gynecological malignancy, but the pathogenesis and biological function for this ovarian cancer remain unknown. We establishment the transgenic mouse model of K-ras(G12D) p53(loxP/loxP) and found that K-ras mutation and p53 deletion within the ovarian surface epithelium gave rise to ovarian lesions with a hyperproliferation and endometrioid glandular morphology. Furthermore, double mutant ovaries formed ovarian carcinosarcomas that were high grade and poorly differentiated. Induction was widely metastatic and spread to abdominal organs including liver, spleen, and kidney at 4 wk. We also confirmed the role of K-ras(G12D) in ovarian cancer cell lines MCAS and PA-1 and showed that K-ras(G12D) overexpression strongly induced cell proliferation, migration, and invasion. The ovarian cancer model we developed recapitulates the specific tumor histomorphology and the probable mechanism of malignant transformation in endometriosis. This article is protected by copyright. All rights reserved.
ResearchGate has not been able to resolve any references for this publication.