PROPORTIONS OF VARIOUS BENIGN BREAST LESIONS AMONG WOMEN PRESENTING AT TERTIARY CARE INSTITUTE OF INDIA: A CROSS-SECTIONAL STUDY

Background and Aim: Benign Breast Diseases (BBDs) is a group of non-cancerous breast diseases. A triple assessment which is done by a clinical examination, imaging like ultrasonography (USG) or mammography and a pathological examination – FNAC or core needle biopsy, during the initial consultation, allows clinicians to give immediate reassurance to most of the patients. The aim of the study was to find out the proportions of various benign breast lesions among women aged 18 years and above. Material and Methods: A prospective study was conducted in the Department of Surgery, Tertiary care institute of India for a period of 20 Months. Based on the pilot study sample size derived was found to be 102. A performa was filled with patient particulars, history and clinical findings in female patient attending department of surgery OPD with breast related symptoms. Patients will be followed up with histopathological, cytological and radiological studies in indicated cases. The patients will be followed up for 1 year. Most common benign breast related symptoms and condition among the study group and probable risk factors for the same will be analyzed. Results:The commonest case among the study population was fibroadenoma 37 (36.27%). The next common was acute breast abscess, followed by fibrocystic disease (9). Lump alone detected either by patient herself or by the clinician was the most common presenting complaint in around 40 patients, followed by lump with pain in around 37, followed by either pain, nipple discharge. Fibroadenoma could be diagnosed clinically with an accuracy of about 89%. Abscess breast, phyllodes tumor and galactocele and few cases of granulomatous mastitis was also able to be diagnosed clinically. Conclusion: Fibrocystic disease is commonest amongst proliferative breast lesions followed by Sclerosing adenosis. Breast abscess is the commonest lesion amongst inflammatory breast lesions. Breast self-examination and health education to females is very important in cases of benign proliferative lesions. Key Words: Benign Breast Diseases, Fibroadenoma, Phyllodes tumor, Ultrasonography

Profiles of Breast Diseases among Women Seeking for Treatment during Covid-19 Pandemic at Surgery OPD of Medical University of Bangladesh

Background: Different pathology of breast is found among the women. Objective: The purpose of the present study was to see the profiles of breast disease among women seeking for treatment during Covid-19 pandemic at the OPD of medical university of Bangladesh. Methodology: This descriptive 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 1625 women were recruited for this study. The mean age with standard deviation of the study population was 36.4±12.54 years. Among 1492 women the most common breast complaints was mastalgia which was 492(29.9%) cases followed by fibrocystic disease, breast lump, fibroadenoma and carcinoma breast which was 296(18.0%) cases, 202(12.3%) cases, 141(8.6%) cases and 84(5.1%) cases respectively. Similarly duct ectasia, fibroadenoma, fibrocystic disease and lipoma were also most common among the less than or equal to 45 years age group of women which were 47(94.0%) cases, 137(97.2%) cases, 269(90.9%) cases and 75(51.4%) cases respectively. Conclusion: In conclusion breast lump and fibrocystic disease are the most common diseases among the women attending during covid19 era. Journal of Current and Advance Medical Research, January 2021;8(1):3-6

Clinic Pathological Evaluation of Benign Breasts Lesion

Introduction: Benign breast lesions are more common than malignant tumours. Hence recognizingthem is important from the viewpoints of therapy and prognosis. Methodology: The materials forthe study comprised of resected specimens of breast lesions received in the pathology departmentKarnataka Institute of Medical Sciences, Hubballi from May 2010 to April 2015. Results: A total of600 cases of benign breast lesions were recorded. Fibroadenoma was the commonest benign breastlesions comprising 70.82%, followed by fibrocystic disease 12%, benign phyllodes tumour 8.3%.The majority of benign breast lesions occurred in the 2nd decade and 3rd decade. Conclusion:Benign breast lesions were common. Conclusion: The most frequently encountered breast lesionswere fibroadenomas. So recognizing them is important for therapy and prognosis.

Factors Associated with Breast Cancer in Women of Reproductive Age at Dr. Pirngadi Hospital, Medan, North Sumatera

Background: Breast cancer has the highest prevalence in Indonesia. The objective of the research was to analyze the risk factors which influenced the incidence of breast cancer in women of reproductive age. Subjects and Method: This was a casecontrol study conducted at Dr. Pirngadi Hospital, North Sumatera. The population was all 15-49 year-old breast cancer women. Sample of 42 women of reproductive age with breast cancer and 42 women without breast cancer was selected for this study. The dependent variable was breast cancer. The independent variables were family history of breast cancer, menarche, history of breastfeeding, and history of fibrocystic disease. The data were collected by questionnaire and medical record. The data were analyzed by a multiple logistic regression. Results: History of family with breast cancer (OR= 4.93; 95% CI=1.33 to 18.28), age of menstruation (OR= 8.46; 95% CI=2.34 to 30.64), history of breastfeeding (OR= 8.46; 95% CI= 2.19 to 32.70), and history of fibrocystic disease (OR= 7.12; 95% CI=1.99 to 25.48) were associated with breast cancer. Conclusion: History of family with breast cancer, age of menstruation, history of breastfeeding, and history of fibrocystic disease are associated with breast cancer. Keywords: breast cancer, history of breastfeeding, women of reproductive age Correspondence: Mila Trisna Sari. Masters Program in Public Health, Universitas Sumatera Utara. Email: [email protected]. Mobile: 08192100- 173.

The effect of hormone therapy on the condition of the mammary glands in women with menstrual disorders of endocrine origin

The objective: to study the effect of stimulating hormone therapy on the condition of the mammary glands depending on the initial endocrine status of women with menstrual disorders in the background and after ovulation stimulation.Materials and methods. The study selected a group of 130 patients (n=130) of reproductive age (mean age 27±2,3 years), which by the nature of menstrual disorders are divided into 2 subgroups: 1 subgroup (n=57) – women with regular menstrual rhythm and insufficiency of the luteal phase (ILP), 2 subgroup (n=73) – women with secondary amenorrhea and oligomenorrhea on the background of chronic anovulation. All patients complained of no pregnancy for an average of 4±1,2 years. After a comprehensive assessment of the reproductive system and hormone-dependent organs, women received the proposed treatment with estrogen-progestogen drug, bromocriptine and ovulation stimulation with clomifene citrate.Results. During the preparatory (diagnostic) phase of the study it was found that in 1 subgroup in 89,5% of patients with concomitant diseases of the pelvic organs and only endocrine disorders of the ILP type in 10,5%. In women of 2 subgroup, the frequency of combined pathology was 23,3%, and endocrine disorders – 76,7%. These results confirmed the need for laparoscopic and hysteroscopic examination of all patients with infertility in addressing the issue of ovulation stimulation. After short cycles (3 months) of monophasic estrogen-progestogen therapy, 31,6% of patients with ILP and 17,1% with anovulation had a positive effect on reducing the incidence of pain in the mammary glands, with the most sensitive to therapy were patients with diffuse forms of fibrocystic disease with a predominance of cystic and glandular components. When resuming biphasic ovulatory cycles with clomifene citrate stimulation, only 5,7% of women complained of breast pain during the first 1–2 cycles. No additional foci in the subgroups were detected, and previously diagnosed fibroadenomas did not increase.Conclusion. Analyzing the obtained data, a positive effect of different types of hormone therapy on the condition of the mammary glands in patients with menstrual and reproductive dysfunction, in particular with diffuse forms of fibrocystic disease with a predominance of cystic and glandular components, is structures most sensitive to normal progesterone levels. Despite the lack of negative dynamics on the background of ovulation stimulation and restoration of normal mammary gland structure after therapy in women with menstrual disorders of endocrine origin, menstrual cycle regulation and dynamic monitoring of the mammary glands are shown to prevent the development of hyperplastic processes.

Modeling of fibrocystic mastopathy in experiment on animals

Nowadays, hormonal imbalance is proven to be a factor that influences initiation of malignant and benign breast tumors. To study the aspects of participation of sex hormones in damage to organs and tissues, it may be necessary to model a common womens pathology fibrocystic disease of mammary glands characterized by the most pronounced effects of this pathogenetic factor, on experimental animals. Aim. To create a model of fibrocystic disease of mammary gland with the subsequent possibility of studying morphological manifestations of the disease in natural and drug-induced pathomorphism. Materials and Methods. The pathology was induced by intramuscular injection of 0.5 ml of 2% synestrol and 0.5 ml of 2.5% progesterone to virgin female rats on the 1st, 7th, 14th, 21st, 28th and 35th days of the experiment. For examination, histological preparations of inguinal mammary glands were made. The preparations were described and studied using morphometric analysis. Results. In the result of the experiment, pronounced macro- and microscopic alterations of mammary glands were found. Microscopic picture was similar to that observed in fibrocystic mastopathy in women. Almost all the morphometric parameters underwent reliable alterations in correspondence with the given pathology. Conclusion. A model of fibrocystic disease of mammary gland was obtained that may be used for further study of morphogenesis and methods of correction.

FNAC OF BREAST LUMP WITH HISTOPATHOLOGICAL CORRELATION

Introduction – FNAC has become increasingly popular in diagnosis of palpable breast masses. As it is sensitive, specific, economical and safe for screening of breast lesions Aims and objectives – to determine the histopathologic correlation of FNAC of breast lumps seen in department of pathology, Govt medical college, siddipet. Methods – 2 yrs. retrospective study if breast lumps , with all patients who had FNAC, with subsequent histopathological confirmation over the period July 2018 –July 2020. A total 232 cases included in which 187 cases are subjected to excision biopsy or mastectomy Results –2 yrs. under review (2018-2020) a total of 232 FNAC of breast lump were done. 197 (84.9%) benign cases, 13(11.6%) malignant cases, 8 (3.5%) inflammatory cases were diagnosed cytologically in which 98(42.24%) cases are fibro adenoma, 27(11.6%) are malignant cases and suspicious of malignancy, 26(11.2%) of gynecomastia, 23(9.91%) of fibrocystic disease with female predominance of 8:1 ratio (206:26). Age ranging from 9 yrs. – 85 yrs. with mean age of 47yrs ± 14.2 yrs. Conclusion – we therefore concluded that FNAC is a reliable diagnostic tool of breast lump in our hospital. FNAC guides the surgeons for further plan of management.

Spectrum of breast diseases in a rural himalayan region of Western Nepal: a hospital based study

Background: Breast diseases, among the most common diseases in females occur in various pat­terns from benign to malignant. Their identification is crucial as some of the benign disorders pose threat to turn into malignancy. This study was aimed to determine the spectrum of breast diseases. Methods: This was a hospital based retrospective study among all the patients in General Surgery OPD of Karnali Academy of Health Sciences, Teaching Hospital, diagnosed with breast diseases during one year period from August 2019 to July 2020 AD. Data were extracted and entered in SPSS version 16 for further analysis. Results: Out of 110 cases, only 4 (3.96%) were male. Almost half 54 (49.09%) of the cases were in the age group of 21-30 years. Fibrocystic disease, Breast Abscess and fibroadenoma, and cracked nipple were 39 (35.45%), 38 (34.54%, 15 (13.63%) and 8 (7.28%) respectively. The benign diseases were seen mostly in the younger population while malignant breast diseases were seen in the older population. Mastalgia was mostly seen in the twenties (17.3%) and the thirties (10%) while Breast abscess was commonly encountered in the twenties (16.4%) and the teens (11.8%). The gynaecomastia were seen only in four males. Conclusions: Fibrocystic breast diseases, Mastitis with or without abscess, fibroadenoma and cracked nipples were the first four most common breast diseases in females. The younger popula­tion had predilection towards the benign diseases which occurred most frequently in the third decade while the malignant occurred in sixth and seventh decade.

Study of Histopathological Patterns in Breast Lumps

Background: Breast lesions in females are heterogeneous diseases that consist of several distinct entities with remarkably different characteristic features. The present study was conducted to assess histopathological findings of excision biopsies of breast lesions.Subjects and Methods:The present study was conducted on 150 cases of lumpectomy breast specimens received in the department of histopathology. The histopathological diagnosis made after routine processing and hematoxlin and eosin staining.Results:The most common age group of presentation was 30 to 50 years having well defined breast mass lesion. The difference was significant (P< 0.05). Among 150 breast specimens, 145 found to be benign and 05 malignant. In benign, common lesions were fibroadenoma in 64, fibroadenosis in 30, Acute Suppurativeinflammatory lesion (Abscess) in 20, fibrocystic disease (FCD) in 22, duct papilloma in 05 and benign phyllodes in 04 cases. In malignant, 04 cases were infiltrative ductal cell carcinoma NOS (Not otherwise specified) and 01 carcinoma in situ. The difference was significant (P< 0.05).Conclusion: Authors found that most common benign breast lesions were fibroadenoma (44.1%) and fibroadenosis (20.6%) followed by acute suppurative inflammatory (Abscess) and FCD.