scholarly journals Cytomorphological study of palpable breast lumps

2015 ◽  
Vol 5 (10) ◽  
pp. 817-819
Author(s):  
PK Choudhary ◽  
A Koirala ◽  
HS Rimal ◽  
A Deo

Background: Breast lump is a very common clinical presentation for which fine needle aspiration cytology is often sought for. Because of it’s significant diagnositic value, FNAC has become a routine tool in the evaluation of the nature of the lesion. The objective of this study was to determine the cytomorphological patterns of breast lump in eastern part of Nepal among individuals attending Nobel Medical College. Materials and Methods: This was a retrospective descriptive study done in department of pathology from December 2012 to June 2015. All individuals presenting with breast lumps was included in this study. FNAC was done as per standard procedure and categorized as per United Kingdom National Health Survey Breast Screening Programme (UK-NHS-BSP) categories and further also categorized in to neoplastic and non-neolastic categories. Results: We studied 771 cases of breast lumps. Occurrence of breast lump was more common in female (97.4%). Neoplastic lesions accounted for 84.1% of cases out of which benign comprised of 94.6% and malignant comprised of 5.6%. Common benign lesions observed were that of fibroadenona (264) and fibrocystic changes (204). Ductal carcinoma was the most common malignant lesions. All malignant lesions were observed in older age and female sex population.Conclusion: Most of the cases of breast lumps are benign in nature and very few accounted for malignant cases. There is predominance of benign lesions in young age and increased malignancy in older age and female population. 

2021 ◽  
Vol 8 (10) ◽  
pp. 562-566
Author(s):  
Mallegowdanadoddi Siddegowda ◽  
Tahniyat Ara

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. KEYWORDS FNAC, Fibroadenoma, Haematoxylin and Eosin, Infiltrating Ductal Carcinoma - Not Otherwise Specified (IDC NOS), May Grunwald Giemsa


2014 ◽  
Vol 2 (2) ◽  
pp. 40-43 ◽  
Author(s):  
Adnan Khan ◽  
Raza Jamali ◽  
Muneeb Jan ◽  
Maria Tasneem

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 <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.


2021 ◽  
pp. 253-255
Author(s):  
Manisha Khare ◽  
Saraswathi J ◽  
Yogita Sable ◽  
Yasmeen Khatib ◽  
Prajakta Gupte

Introduction: Fine needle aspiration cytology (FNAC) is a simple cost-effective and rapid diagnostic modality for the evaluation of breast lumps. The aim of the present study was to correlate the cytological diagnosis with histopathological ndings and to nd out the accuracy of FNAC in the evaluation of breast lesions. FNAC is very helpful in distinguishing benign from malignant lesions and deciding the further management of the patient. Materials And Methods: The study comprised of 250 cases of FNAC of palpable breast lesions with histological correlation. All the aspirates were examined using PAP and Giemsa stains. The accuracy of FNAC was calculated by determining the sensitivity, specicity, positive predictive value, negative predictive value and accuracy. Results: Total 250 cases were studied of which there were 246 female and 4 male patients. A concordant diagnosis was made on FNAC in 134 out of 136 of benign lesions, one of two cases of suspicious for malignancy and all 112 cases of malignant lesions. Fibroadenoma(FA) (63.2%) was the commonest benign lesion observed while ductal carcinoma (42%) was the most frequent malignancy seen. In the diagnosis of breast lesions FNAC had a sensitivity of 99.12%, specicity of 98.54%, positive predictive value of 98.25%, negative predictive value of 99.26% and accuracy of 98.8%. Conclusion: FNAC is a reliable tool for diagnosis of breast lesions. It is minimally invasive and is a good alternative to biopsy in the diagnosis of benign lesions. However for the cases which fall into “suspicious for malignancy” category biopsy is advisable.


2021 ◽  
pp. 1-7
Author(s):  
Cong-Gai Huang ◽  
Meng-Ze Li ◽  
Shao-Hua Wang ◽  
Xiao-Qin Tang ◽  
Johannes Haybaeck ◽  
...  

<b><i>Introduction:</i></b> We intend to determine the diagnostic power of fine needle aspiration biopsy (FNAB) for differentiation between malignant and benign lesions on axillary masses and draw the physicians’ attention to the benefits of FNAB cytology in the diagnosis of axillary masses. <b><i>Methods:</i></b> In this study, 1,328 patients with an axillary mass diagnosed by FNAB were retrospectively reviewed. These cases were registered at the affiliated hospital of Southwest Medical University (China), July 2014 to June 2017. Cytological results were verified either by histopathology following surgical resection or clinical follow-up. <b><i>Results:</i></b> Of the 1,328 patients affected by axillary masses, 987 (74.3%) cases were female, and 341 (25.7%) cases were male. The highest incidence of patients was in the age group of 41–50 years (375, 28.2%). There were 1,129 (85.0%) patients with benign lesions and 199 (15.0%) with malignant lesions. Of the 199 malignant lesions cases, 21 cases were lymphomas, 2 cases were accessory breast cancers, and 176 cases were lymph node metastatic tumors. Under lymph node metastases, the most frequent primary tumors were breast cancer (141, 80.1%), followed by lung cancer (21, 11.9%). According to the study, the characters of 1,328 cases showed statistically significant difference (χ<sup>2</sup> = 4.534, <i>p</i> = 0.033), and the incidence of females with axillary mass was significantly higher than that of males. There was a statistically significant difference in the distribution of benign and malignant cases in the patient age groups (χ<sup>2</sup> = 1.129, <i>p</i> = 0.000), and the incidence of patients of 41–50 years of age was significantly higher than that of other patients. The diagnostic accuracy of FNAB in axillary masses was analyzed with the results of 95.98% of sensitivity, 99.56% of specificity, 97.45% of positive predictive value, and 99.29% of negative predictive value. <b><i>Conclusion:</i></b> Our results confirm that FNAB is a valuable initial screening method regarding pathologic diagnosis of axillary mass, in particular with respect to malignancy in 41- to 50-year-old female patients.


2021 ◽  
Vol 8 (5) ◽  
pp. 1650
Author(s):  
Subhransu Kumar Hota ◽  
Ranjana Giri ◽  
Hardik Kabra ◽  
Devika Chauhan ◽  
Prita Pradhan ◽  
...  

Breast lumps have diverse causes including benign as well as malignant lesions. Fibroadenoma (FA) is a common cause of breast lump. Complex fibroadenomas, a particular subtype, pose diagnostic dilemmas due to confusing the radiological findings and hold higher incidence of transformation to malignancy. A 49 year old female presented with a painless lump in right breast for 2 years which appeared calcified on radiology. Excision biopsy was performed which grossly revealed an encapsulated grey-white firm to hard with cystic areas. Microscopically the sections showed a well encapsulated fibroepithelial tumor showing areas of sclerosing adenosis, hyalinization, cysts lined by cuboidal cells with eosinophilic secretions, areas of calcification and ossification. No evidence of lobular hyperplasia or in-situ carcinoma was seen. Patient was advised follow up. This case represents the unusual occurrence of complex fibroadenoma in a middle-aged female showing with ossification.


2020 ◽  
Vol 7 (5) ◽  
pp. 1452
Author(s):  
Sumedha Laul ◽  
Divish Saxena ◽  
Nitin Wasnik

Background: A palpable lump in a woman’s breast could be benign or malignant and it requires prompt evaluation to confirm or exclude cancer. This study aims to establish the correlation between clinical and radiological parameters for provisional diagnosis of breast lumps and the role of histopathology for final diagnosis of these breast lumps.Methods: Total 275 female patients with palpable breast lumps were included in the study, where a detailed history was recorded and clinical examination was done. All patients underwent ultrasonography of the breast along with fine needle aspiration cytology or histopathology, wherever indicated.Results: Benign breast lumps were found more commonly in 18-30 years of age group whereas malignant breast lumps were seen more commonly in the 41-60 years age group and the incidence increased with age. Fixity to skin was present in 5.1% and fixity to chest wall was present in 5.8% respectively, and all of these cases turned out to be malignant.Conclusions: Attributing factors for suspicion of malignant lumps are advanced age, fixity to surrounding structures, presence of ulceration and peau’d orange breast skin appearance. Although for confirmation of malignancy from a suspected breast lump requires either cytology or histopathology of the excised specimen.


2009 ◽  
Vol 127 (2) ◽  
pp. 66-70 ◽  
Author(s):  
Renato Coimbra Mazzini ◽  
Simone Elias ◽  
Afonso Celso Pinto Nazário ◽  
Cláudio Kemp ◽  
Ângela Flávia Logullo

CONTEXT AND OBJECTIVE: Genetic abnormalities in cell proliferation-regulating genes have been described in premalignant lesions. The aims here were to evaluate c-myc protein expression in non-palpable breast lesions associated with microcalcifications, detected by screening mammography, and to compare these results with histopathological, clinical and epidemiological variables. DESIGN AND SETTING: Analytical cross-sectional study, with retrospective data collection, in a university hospital in São Paulo. METHODS: Seventy-nine female patients who underwent routine mammography between 1998 and 2004 were studied. Lesions classified by the Breast Imaging Reporting and Data System (BI-RADS) as 4 or 5 underwent percutaneous biopsy using a large-core needle. Ninety-eight lesions were studied anatomopathologically. Paraffin blocks properly representing the lesions were selected for immunohistochemical analyses using the streptavidin-biotin-peroxidase technique with monoclonal mouse c-myc antibodies. RESULTS: Among the 98 lesions, 29 (29.6%) contained malignant neoplasia; 40 (40.8%) had a positive immunohistochemical reaction for c-myc. When the groups were divided between lesions without atypias versus atypical lesions plus malignant lesions, 31.03% of the 58 lesions without atypias were positive for c-myc and 55% of the 40 malignant and atypical lesions (P = 0.018). Comparing the atypical lesions with ductal carcinoma in situ versus the benign lesions without atypias, c-myc was present in 51.61% of the 31 atypical lesions and 31.03% of the benign lesions without atypias (P = 0.057). CONCLUSION: C-myc protein was more frequently expressed in atypical and malignant lesions than in benign lesions without atypias. C-myc expression correlated with the presence of atypias (P = 0.018).


KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 780-786
Author(s):  
Shaheen Akter ◽  
Md Jahidul Islam ◽  
Md Shariful Haque

Background: With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lumps has been revolutionized and it has high sensitivity and specificity.Aim: In this study we analyze the spectrum of FNAC diagnoses in breast lumps and compare the diagnostic accuracy of fine FNAC in differentiating the benign and malignant lesions of breast lumps with histopathological correlation.Materials & Methods: Two years prospective study was conducted in our institution and in that 490 aspirations, including 6 bilateral were performed. Suppurative and inflammatory lesions were excluded from the total aspirates. The cytological diagnosis was classified into 3 groups benign, suspicious and malignant. After this reporting all the available 94 cases were later subjected to mastectomy or open/excision biopsy and followed-up by histopathological confirmation. Later diagnostic accuracy of cytology reporting was compared with that of histopathology.Results: A total of 490 FNAC cases were reported including 373 as benign, 4 as suspicious for carcinoma and 113 as carcinoma. Majorities were premenopausal females and commonest age group was 31-40 years. Among them only 94 cases were followed-up by histopathologic confirmation. In histopathological correlation study, we had accuracy rate of 100% for benign lesion and 92.10% for malignant lesion with false negative rate of 7.90% and false positive rate of zero with fine needle aspiration cytology in the diagnosis of palpable breast lump. The overall sensitivity of fine needle aspiration in diagnosing the palpable breast lump is 92.10%, specificity is 100%, positive predictive value is 100% and negative predictive value is 94.91%.Conclusion: FNAC in experienced hands is a very useful tool with very high specificity and rare false positive result. Sensitivity can be further improved with clinical and imaging correlation.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 780-786


2021 ◽  
Vol 7 (3) ◽  
pp. 144-149
Author(s):  
Manasa GC ◽  
◽  
Sneha SP ◽  
Adicherla Govardhan ◽  
◽  
...  

Introduction- The vast majority of the lesions that occur in the breast are benign. Much concern isgiven to malignant lesions of the breast because female breast cancer has now surpassed lungcancer as the leading cause of global cancer incidence in 2020. Fine needle aspiration cytology(FNAC) has good sensitivity, specificity and accuracy in the diagnosis of both neoplastic and non-neoplastic breast lump thereby assisting in early diagnosis and further management. The currentstudy was done to study the incidence and the different cytomorphological patterns of palpablebreast lumps by FNAC and consequently compare the results with studies in the literature.Materials and methods- This is a retrospective study conducted from January 2018 to December2020 in a tertiary care hospital. The three-year data is obtained from the records maintained in theFNA clinic. The patients were counselled before the procedure and informed consent was taken.Results- A total of 1193 breast lump cases were analysed in this 3-year study, there were 19 malepatients all of them presented with gynaecomastia and 1177 female patients. The patient’s agegroup ranged from 12 to 86 years. The commonest age group with the lesions 31-40 yearscomprising 326 cases (27.32%) followed 21-30 years age group in the second place with 307 cases(25.7%). Conclusion- In this study the most common benign neoplastic and malignant neoplasticbreast lumps are fibroadenoma and infiltrating ductal carcinoma respectively. Fibrocystic disease ofthe breast is the most common non-neoplastic breast lump.


1989 ◽  
Vol 75 (6) ◽  
pp. 589-593 ◽  
Author(s):  
Oronzo Palma ◽  
Nevio Canali ◽  
Paolo Scaroni ◽  
Anna Maria Torri

In the management of 29 patients by needle aspiration biopsy, a 100 % accuracy was obtained in the diagnosis of intra- and extra-bulbar orbital lesions. The technique did not produce any important traumatic complications; there was moderate subconjunctival hemorrhagic suffusion, which spontaneously resolved. The technique proved to be positive in the diagnostic approach to lesions with a difficult access. Its importance in the choice of treatment is discussed, and its effect on the prognosis of intraocular tumors is emphasized. It can indeed give specific indications for early treatment of malignant lesions and avoid radical surgery of pseudoneoplastic benign lesions. As in other sites, the technique is reliable if it is applied in cooperation with an experienced pathologist. It is simple and rapid, inexpensive and well accepted by patients more than other invasive diagnostic procedures.


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