Vol. 5, Issue 11 (2016)

Author(s):
Ashish Gupta

Abstract:
Introduction: In India, breast carcinoma is the second most common malignant neoplasm next to cervical cancer in females. It is the leading cause of morbidity and mortality. Breast cancer is now the most common cancer among Indian females (around 30%) and has speedily replaced cervical cancer. All breast lesions are not malignant, and all the benign lesions do not progress to cancer; however, the accuracy of diagnosis can be increased by a combination of preoperative tests. The minimally invasive method includes fine needle aspiration cytology (FNAC). It is a simple technique readily tolerated by patients, does not require anesthesia. Materials and Methods: This prospective hospital-based study was conducted in the department of pathology in tertiary care hospital. The patients suffering from breast lump were included in the present study. All the details were observed and noted like clinical history and meticulous physical examination including the duration, size, consistency and mobility. 22-24G needles attached to 10cc syringes were used for the FNAC FNA. The prepared smear from the aspirates was fixed in 95% ethyl alcohol and then those smears were stained with Papanicolaou and Hematoxylin and Eosin (H and E) stains. Air dried aspirates smear was stained with Giemsa and for the study of cytological diagnosis of granulomatous disease Ziehl-Neelson (ZN) staining was performed. The biopsy specimens were fixed in 10% formalin for 24 hours for histopathological examinations and then gross examination and cut section findings were done. From each block, sections were cut at 4-5 microns thickness and stained with H and E. Results: Total 50 patients having breast lumps were studied; all patients were female with age group 15 years to 60 years. Among 50 patients 40 (80%) were benign and 10 (20%) were malignant. The maximum benign cases were studied in age range of 15-20 years of age 20 (40%) and malignant cases ranged from 21 to 60 years with a majority of cases in the age group of 41-50 years 6 (60%). All the palpable breast lumps were in the range of 1-5 cm and 23 breast lumps measured 1.1-2 cm, among them 4 cases (17.40%) were malignant, followed by range of 2.1-3 cm, 3.1-4 cm, less than 1 cm and more than 4.1 cm cases were 15, 6, 5 and 1 respectively. Among total patients 26 (52%) cases were in right breast and 24 (48%) cases were in left breast. Among all the four quadrants, superolateral quadrant was the most common for breast lesions 26 (52%). 40 (80%) cases were benign with the majority of cases 15 (37.5%) being fibroadenoma, followed by fibrocystic change 11 (27.5%), inflammatory/ mastitis 6 (15%), galactocele or lactational changes 5 (12.5%), gynecosmastia 2 (5%) and one case was benign phyllodes tumour (2.5%). Conclusions: Breast lump is a common clinical presentation with wide differential diagnosis including malignancy which has increased incidence in recent times. FNAC is a very important preliminary diagnostic test in breast lesions; the results show a high degree of correlation with the final histopathology report with USG.