Showing papers on "Breast lumps published in 2010"

Misconceptions about Breast Lumps and Delayed Medical Presentation in Urban Breast Cancer Patients

Abstract: Background: Despite current recommendations for women to be screened for breast cancer with mammography every 1 to 2 years, less than half of all newly diagnosed breast cancers are initially detected through screening mammography. Prompt medical attention to a new breast symptom can result in earlier stage at diagnosis, yet many patients delay seeking medical care after becoming aware of a breast symptom. Methods: In a population-based study of breast cancer, we examined factors potentially associated with patient delay in seeking health care for a breast symptom among 436 symptomatic urban breast cancer patients (146 white, 197 black, and 95 Hispanic). Race/ethnicity, socioeconomic status, health care access and utilization, and misconceptions about the meaning of breast lumps were the key independent variables. Results: Sixteen percent of patients reported delaying more than 3 months before seeking medical advice about breast symptoms. Misconceptions about breast lumps and lacking a regular provider, health insurance, and recent preventive care were all associated with prolonged patient delay ( P < 0.005 for all). Misconceptions were much more common among ethnic minorities and women of lower socioeconomic status. Conclusion: Reducing patient delay and disparities in delay will require educating women about the importance of getting breast lumps evaluated in a timely manner and providing greater access to regular health care. Cancer Epidemiol Biomarkers Prev; 19(3); 640–7

Breast cancer: demographic characteristics and clinico-pathological presentation of patients in Iraq.

Abstract: Breast cancer is the commonest type of malignancy in Iraq. The study was carried out on 721 out of a total of 5044 patients (14.3%) presenting with palpable breast lumps that were diagnosed as cancer. Approximately one third of the breast cancer patients were diagnosed at age 40-49 years; 71.9% came from urban areas; and 75% were married. History of lactation was reported in 63.1% and hormonal therapy in 29%. Positive family history was recorded in 16.2%. Although the lump was detected by the patient herself in 90.6% of cases, only 32% sought medical advice within the first month. Accordingly, 47% of these patients presented in advanced stages (III and IV). The main histological type was invasive ductal carcinoma, in which pathological changes of grade II and III were observed in 56.6% and 39.9% respectively. DNA analysis showed that 80.3% of the carcinomas were aneuploid. The findings of this study justify increasing efforts for establishing comprehensive breast cancer control programmes in Iraq.

Breast fibroadenomas in the pediatric population: common and uncommon sonographic findings.

Abstract: Sonography is usually requested to evaluate palpable pediatric breast lumps, and solid masses are almost always fibroadenomas. Lack of familiarity with the findings of fibroadenomas can lead to diagnostic uncertainty and sometimes unnecessary biopsy and excision. We sought to review the spectrum of sonographic findings in our cases of pathology proven pediatric fibroadenomas. The purpose of this retrospective study was to describe the sonographic appearances of pathologically proven pediatric breast fibroadenomas. A query of the Department of Radiology database at our institution was performed for all patients younger than 19 years who underwent breast US from January 2001 to June 2009. A total of 332 patients were identified: 282 girls (85%) and 50 boys (15%). Ninety-one girls and no boys had a solid breast mass based on US findings. Forty-three children had a total of 49 pathologically proven breast masses with the diagnoses of fibroadenoma (44), hamartoma (1), non-Hodgkin lymphoma (1), tubular adenoma (1), pseudoangiomatous stromal hyperplasia (1) and lactation changes (1). Reviews of medical records, histological results and sonographic examinations of all pathology-proven fibroadenomas were performed. US findings were characterized according to location, multiplicity, size, shape, echogenicity and homogeneity, definition of margins, posterior acoustic features and Doppler vascularity. The vast majority of solid breast masses in girls are histologically benign. Fibroadenomas accounted for 91% of the pathologically proven solid breast masses. Common findings on US imaging are an oval shape, hypoechoic echo pattern, posterior acoustic enhancement and internal Doppler signal. Lobulations were found in 57% of the masses. Less common findings are absent internal vascular flow and complex echo pattern, while isoechoic echo pattern, posterior shadowing and angular margins are rare or unusual. Fibroadenomas represent the most common solid mass in the breasts of girls. Sonographic appearances are usually characteristic and do not significantly differ from those found in adults. The radiologist must be aware of common and uncommon sonographic appearances of fibroadenomas in the pediatric age group and should be cautious when recommending histological confirmation based on imaging findings, as breast malignancy is extremely rare.

Frequency of breast cancer among sudanese patients with breast palpable lumps

Abstract: Background: Breast cancer mortality is high in Sudan and most patients are detected at later stages of the disease due to the lack of awareness and absence of screening programs. This study aimed to determine the pattern and frequency of breast cancer among patients presenting with palpable breast lumps within one year duration. Settings and Design: As a part of the continuous development in cancer management, this descriptive longitudinal study was conducted in Khartoum, Sudan. Methods and Materials: We obtained information (patient's personal data) and Fine-Needle Aspiration (FNA) materials, for occurrence of 200 breast lesions in patients. Statistical Analysis Used: Data were analyzed by using a computer SPSS program. Results: The diagnoses of the 200 breast lesions were as follows: 68 (34%) were malignant, 56 cases (28%) were fibroadenoma, 23 cases (11.5%) were fibrocystic change, 22 cases (11%) were inflammatory lesions (including mastitis and abscess formation), 12 cases (6%) were benign cysts and the remaining 19 patients (9.5%) were with lactation changes (8 cases), lipoma (6 cases), gynecomastia (3 cases) and phyllodes tumor (2 cases). Regarding gender, only 6 patients (0.03%) were males of whom 3 (50%) were diagnosed with gynecomastia. Conclusions: The frequency of advanced breast cancer among patients with breast lesions is high, in this subset of patients, which signals the urgency for implementation of breast screening programs.

Significance of nuclear morphometry in cytological aspirates of breast masses.

Abstract: Background : Breast carcinoma is the most common malignancy globally. Cytological evaluation in breast lesions is largely subjective. Gradual progression of cells from normal to invasive involves nuclear changes that need to be viewed objectively. Aims : This study aims to apply nuclear morphometry on cytological breast aspirates. It evaluates its utility in differentiating benign vs. malignant lesions and correlates it with cytologic grading in malignant cases. Setting and Design : Nuclear morphometric parameters of malignant and benign cases were compared. Parameters of malignant cases were correlated with cytologic grading. Materials and Methods : Cytology was used to categorize aspirates from breast lumps into malignant (53 cases) and benign (29 cases). One hundred cells per case in both groups were mapped on DEBEL Cytoscan and six geometrical and three textural parameters obtained were compared. In malignant cases, morphometry was correlated with Robinson's cytologic grading, which was further correlated in tissue sections (45 cases) with modified Scarff-Bloom-Richardson histologic grading. Statistical Analysis : Students t-test was applied for comparison between benign and malignant cases. One-way ANOVA followed by Bonferroni's post hoc comparison was applied to compare the three cytologic grades. Results were considered significant when P Results : Nuclear morphometry successfully differentiated between benign and malignant aspirates and correlated significantly with cytologic grades. Morphometry was especially useful in the diagnosis of atypical ductal hyperplasia and ductal carcinoma in situ. Useful parameters were mean nuclear area, long axis, short axis and total run length. Cytohistologic correlation was 83.3%, 88.9% and 88.9% for cytological grades 1, 2 and 3 respectively. Conclusions : Nuclear morphometry was thus a useful objective tool in the evaluation of breast masses.

Triple assessment in the diagnosis of breast cancer in Kashmir.

Abstract: Background Although the diagnosis of breast cancer is suggested on clinical examination, the degree of suspicion is variable. Currently a combination of three tests, i.e. clinical examination, radiological imaging (mammography, ultrasonography) and pathology called as triple assessment test is used to accurately diagnose all palpable breast lumps. Together they give sensitivity of 99%. The triple assessment is taken as positive if any of the three components is positive and negative only if all of its components are negative for malignancy.

A clinicopathologic study of breast lumps in Bhairahwa, Nepal.

Abstract: BACKGROUND Various types of lesion from inflammation to carcinoma can affect breast. Some lesions are common in young females while others in elderly age group. Early presentation and prompt diagnosis is essential to relieve anxiety of non-neoplastic conditions, and in case of carcinoma, it can save the patient from metastases. Many cases related to breast lesions from the region are reported in the surgery clinics of this institute and various breast diseases are being managed in the clinical departments. Analysis of pattern and prevalence will be a valuable guideline for clinicians of this location to compare with that of others. METHODS In the retrospective clinical study during 9 years period, the cases of breast lesions and lumps underwent fine needle aspiration cytology. Pap staining was done in alcohol fixed smears. The doubtful cases 65 were diagnosed through histopathological examinations by conventional method of fixation, processing and staining with routine hematoxylin and eosin. The cases with undetermined and inconclusive material were excluded from the study. RESULTS In the study of total 243 cases, inflammatory conditions 22.6%, fibrocystic change 41.2%, fibroadenoma 21.8%, other benign breast disease 4.5%, gynaecomastia 2.5% and carcinoma 7.4% were detected. CONCLUSION Fibrocystic change was the commonest lesion in this study with 33 years as the average age of presentation. However, malignancy was detected above 40 years of age.

Pattern Of Breast Lumps And Diagnostic Accuracy Of Fine Needle Aspiration Cytology; A Hospital Based Study From Pondicherry, India

Abstract: Introduction Breast cancer is the second most common cancer in women. FNAC is simple, rapid and safe method to diagnose breast lumps. FNAC has high sensitivity, specificity and accuracy.Objectives The aim of study was to correlate the FNAC diagnosis with histopathology and to find out the pattern of breast lump, sensitivity and specificity of FNAC in diagnosis of breast lumps in our institution. Method The present study was done in department of Pathology of Sri Venkateshwara Medical college Hospital and research Centre, Pondicherry, India from June 2008 to May 2010. The FNAC was done in 102 cases and histopathology was available in 77 (75.49%) cases for correlation with cytology.ResultsThe result shows 3.92% cases were male while 96.08% female. Age of the patient was range from 1652 years with mean age of 30 years. In our study fibroadenoma was most common benign lesion in the breast which account 45.09% of the total breast lesion, and 89.1% seen in the age group of 10-30 yrs. Study includes 9(8.82%) cases of malignancy with mean age of 46 years. The sensitivity and specificity for malignancy were found to be 84.6% and100% respectively.ConclusionFNAC is highly sensitive and specific technique for diagnosis of most of the breast lumps. FNAC can be used preoperatively to avoid unnecessary surgery and discomfort during open biopsy.

Pattern of presentation and management of ca breast in developing countries. There is a lot to do.

Abstract: Objective: To investigate the pattern of presentation, severity, factors responsible for delayed presentation and outcome of breast cancer in patients presenting to a teaching hospital of Jamshoro. Methods: It's a prospective descriptive study of 103 malignant breast lumps treated at a tertiary care teaching hospital over a period of 8 years. All patients were admitted through Outpatients department and were thoroughly examined and investigated. Treatment offered was based on triple assessment and ranged from lumpectomy to toilet mastectomy depending upon the stage of disease. The variables studied were recorded on a proforma and analyzed on SPSS version 12 for measuring frequencies and using Chi square test where applicable. Results: The mean age of the study population was 39.17 ± 6.019 years and a range of 22 to 54 years. The frequency of advanced malignancy was alarmingly high in younger patients. Intra- ductal carcinoma was the commonest tumour in 93 (90%) patients, while the remaining included lobular (07) and Paget's disease (03). The high figures of advanced disease at presentation is attributed to lack of knowledge and education, poverty and local customs of women not exposing themselves even to the physicians. In addition, there is a substantial delay in the referral of patients from under privileged, remote areas where patients continue to receive symptomatic treatment till such time that disease becomes incurable. Conclusion: Advanced breast disease is common in younger patients belonging to underprivileged and remote rural areas. Great efforts are required to educate people so as to make early diagnosis possible.

Knowledge and Practice of Breast Self Examination among Female Students in a Sub Saharan African University

Abstract: Background: Breast cancer is the most common cancer among women in many parts of Africa. Facilities for screening and early detection are extremely limited yet early diagnosis improves survival. This study explored the practice of Breast Self Examination among female university students as a means of screening and early detection in a low resources environment. Subjects and Methods: A cross sectional descriptive study at a Sub Saharan university. A call for volunteers to the study was made; a pretested standardised questionnaire was used for data collection. The process was limited to an interview and a physical examination. IRB approval was granted before the study began. Results: A total of 320 participants volunteered, 314 were recruited. The majority were aged between 21 and 25. The range was between 19 to 31 years. There was a high awareness of Breast self Examination (BSE) of 81.5%, 30% had ever performed a BSE, 14% performed it regularly, 8% knew the correct monthly timing, the technique was accurately demonstrated by 1% of participants. 4.8 were found to have breast lumps. Conclusion: There is a likelihood of most young women in the country practicing BSE inadequately. There is a need for widespread BSE campaigns emphasizing the correct technique and a need to evaluate BSE efficacy. The prevalence of breast lumps among young women attending this university was comparable to other community prevalence studies in this age group.

Pattern of breast masses ing Lagos: A private health facility review of 189 consecutive patients.

Abstract: BACKGROUND The increasing awareness concerning breast cancer has led to significant interest in breast masses in general. As a result there is considerable interest in the clinicopathologic studies of breast masses in various populations. OBJECTIVE To study the clinicopathologic pattern of breast masses at a private health facility in Lagos, Nigeria. METHOD The records of all patients who presented between January 1993 and December 2002 with breast lumps at the Lagoon Hospital Apapa were reviewed. Their biodata, clinical presentation and histopathological diagnosis were retrieved. RESULTS 189 consecutive patients were studied comprising of 180 females and nine males. The peak age incidence for benign disease was 21-30 years while it was 31-40 years for those with malignant masses. Majority (66.1%) presented with painless solitary lumps. 46 (77.2%) patients had benign lumps while 43 (22.8%) had malignant lesions. The commonest benign lesion was fibrocystic disease (47.9%) while infiltrating ductal carcinoma was the commonest pathological diagnosis in the malignant group (83.1%). CONCLUSION From this study benign breast masses outnumber malignant ones by more than 3:1 in this population. The commonest pathological diagnosis was fibrocystic disease in benign lesions and infiltrating ductal carcinoma for malignant masses.

Measuring performance in clinical breast examination

Abstract: Background: Clinical breast examination (CBE) remains an essential part of triple assessment of breast lumps, but to date there are no performance measures for clinicians using this technique The aim of this retrospective audit was to compare the performance and accuracy of CBE to identify key indicators that could be used to monitor performance prospectively Methods: Clinical examination findings (E1, normal, to E5, malignant) for 16585 patients who had CBE as part of triple assessment were obtained from electronic medical records The performance of CBE, by age group, mammographic density and clinician, was assessed by calculating the sensitivity, specificity and area under the receiver operating characteristic (ROC) curve Results: There was marked variation in sensitivity between clinicians (range 44·6‐65·9 per cent) There was a strong downward trend in the percentage classified as E5 as sensitivity for breast cancer detection decreased, and a corresponding strong downward trend in the proportion of E4 and E5 cancers classified as E5 Both of these measures could be used as indicators to monitor CBE performance Conclusion: The performance measures outlined here could help to identify clinicians who have a lower sensitivity for CBE and who may therefore require feedback and further training

Increased risk of breast cancer in multiparous and lactating women attending a breast care clinic in Pakistan: a paradigm shift?

Abstract: Aims and Objectives: A changing paradigm shift with multiparity (MP) and breast feeding (BF) has been reported in recent years in breast cancer (BC). Our aim was to observe associations of parity, BF and other risk factors with BC among a local population attending a breast care clinic. Materials and methods: A total of 1,039 women (mean age 39 ± 15 years) attended for screening or presented with palpable breast lumps at KIRAN, Pakistan. The majority were in middle and low socioeconomic strata. As per American Cancer Society (ACS) guidelines 2003, mammography and ultrasound were performed, along with fine needle aspiration cytology (FNAC) in 195 women with Breast Imaging Reporting and Data Set (BIRADS) IV/V, high risk patients with BIRADS III on mammography and with suspicious ultrasound findings. Results: The study population was stratified into two groups; one with BC on FNAC in 181 women (17% p<0.001) and other including 858 healthy women after screening for cancer. The BC group had relative predominance of MP (86% p<0.001), BF (85% p<0.001), family history FH (8% p=0.106) and post-menopause PM (49% p<0.001) as compared to the healthy population. Estimated relative risk (RR) of BC in women with MP, BF, F/H and PM was 3.12 (95% CI=2.054.73; p <0.001), 2.47 (95%CI=1.69-3.61; p<0.001), 1.45 (95%CI=0.93-2.41; p=1.06) and 2.33 (95%CI=1.70-3.02; p<0.001) respectively. Higher incidence of BC was observed between 30-40 years 23% (p<0.001) and between 40-50 years 38% (p<0.001). Conclusion: MP, BF and PM have significant associations with BC in the studied Pakistani women and this possible paradigm shift now needs to be evaluated for confounding factors.

Fibroadenoma of the breast in a man associated with adenocarcinoma of the rectum and polyposis coli.

Abstract: Fibroadenoma of the breast is an uncommon cause of breast lumps in men. Only a few cases have been reported in the literature, the majority of which were prescribed estrogen. We present herein the first case of a fibroadenoma of the breast in a 68-year-old man with adenocarcinoma of the rectum and polyposis coli. In this case, there was neither estrogen treatment nor any other medications which have been discussed in the literature as inducing fibroadenomas. Fibroadenomas in men without hormone treatment and with normal hormone levels are extremely rare and the developmental mechanism of the breast fibroadenoma in this man is under question.

Development of portable breast self-examination device using enhanced tactile feedback

Abstract: A simple tactile imaging system for detecting possible breast lumps is proposed. The breast cancer detection system (BCDS) consists of a palm-sized, portable, wireless scanning probe with a nine-force sensor array, a web camera, and a PC program to display the location and stiffness of hard breast lesions based on tactile pressure profiles. The results of performance evaluation tests using various breast phantoms demonstrated that palpable abnormalities larger than 5 mm located at depths less than 25 mm can be detected accurately. It is expected that this low-priced BCDS will extensively benefit all adults and ubiquitous healthcare services who apply regular breast self-examination by providing remote magnified palpation with enhanced tactile sensitivity.

Comparative demographic and clinicopathological study on the behavior of mammary carcinoma in three Iraqi governorates (Baghdad, Hilla and Karbala)

Abstract: Summary: Background: Breast cancer is the most common malignant tumor in women worldwide. In Iraq, there is a tendency for this disease to be diagnosed in younger ages, at advanced stages with a prevalence of more aggressive tumor behavior. Patients and Methods: The study included a total of 216 women with breast lumps and proven breast cancer who visited the Main Referral Training Center for Early Detection of Breast Tumors in the Medical City Teaching Hospital in Baghdad (85 patients) and the Specialized Clinics belonging to the major hospitals of Hilla (62 patients) and Karbala (69 patients) complaining of apparent breast lumps. Results: 31% of patients was in the age category (40-49 years), 38.4% of patients whose highest education within the primary school level, 36.4% of patients had history of lactation, 52.3% of total had started menstruation at the age (10-12 years), 85% of patients had negative history of oral contraceptive pills consumption, Ki-67 tumor marker was demonstrated in 62.5% of total with highest frequency of expression was displayed in Baghdad and in relation with grade II. Conclusion: Significant differences among the three Iraqi governorates were noted with respect to patient’s age, educational status, history of breast feeding, age at menarche and history of oral contraceptive pills consumption. Higher Ki-67 nuclear expressions were demonstrated among patients from Baghdad. There was a direct significant relationship between Ki-67 nuclear expression and the nuclear staining intensity with tumor grades.

Tuberculosis of the breast: medical treatment.

Abstract: Two patients with breast tuberculosis (BT) were discussed. In the presentation of each of the patients were a breast lump without pain and purulent discharge. There was associated axillary lymphadenopathy in one patient. Diagnoses were done by open biopsy and only antitubercular therapy was given to the patients. After two months of therapy, the breast lumps disappeared completely from both patients. Treatment was continued for 9 months. In breast tuberculosis, medical therapy can be used without further surgical intervention.

Breast lump detection: who is more accurate, patients or their GPs?

Abstract: Summary Aims: A breast lump is the most commonly presenting complaint given by GPs when making a referral to the local breast unit. This does not necessarily mean that this was the breast symptom for which the woman consulted her GP. This study aimed to assess the accuracy of women and their GPs in detecting true breast lumps. Materials and Methods: Between October 2008 and March 2009, the patients’ symptoms, the signs elicited by the GP and the examination findings of the specialist breast clinician (BC) were recorded and compared for every consecutive new referral to the symptomatic breast clinic. A true lump was considered to present if it was detectable by the BC. Results: Of the 282 referrals, 228 (81%) were for a lump. Women were 95% sensitive and 59% specific in detecting a true lump. GPs were 98% sensitive and 34% specific. Forty-six patients were referred by their GP with a lump but denied that one was present in themselves. Cancer was diagnosed in four of these women, three of whom suffered from dementia. Discussion: Patients’ and GPs’ breast assessments are highly sensitive in detecting breast lumps. The specificity of GPs’ assessments is low. The results reflect the high level of awareness that breast cancer usually presents as a lump and the priority given to not missing cancer. In the subgroup of cognitively unimpaired women referred with a lump, but who themselves deny that one is present, the patient will be correct and the GP incorrect in their assessment in 96% and 95% of patients respectively. Conclusion: If a woman consults her GP with breast symptoms, but has not found a lump, it is safe for her GP not to find one either. Such patients can be reassured and reviewed after a month with a view to referral, if symptoms persist.

Evaluation of Triple Assessment Modalities in the Management of Palpable Breast Lumps

Abstract: Department of Surgery AL-Jamhoory Teaching Hospital Mosul Medical City Iraq. diagnostic approach of palpable breast lumps should involve the use of rapid, inexpensive, most accurate and least invasive methods to evaluate and distinguish between benign and malignant lumps in out patient clinics, such methods would benefit both patients and surgeons by  Promoting proper preoperative diagnosis and management.  Further limits unnecessary testing and procedures (2,3,4) . ABSTRACT: BACKGROUND: Breast masses are common clinical presentation in breast clinics, their managements require an efficient and accurate evaluation, using the least invasive, most accurate methods that cause minimal patients discomfort and limit any unnecessary procedure. OBJECTIVE: This study is designed to evaluate the diagnostic accuracy of triple assessment (a combination of clinical examination, imaging studies and tissue sampling) in the preoperative assessment and optimal management of palpable breast masses. PATIENTS AND METHODS: This clinical prospective study which was conducted in mosul breast center, department of surgery, aljamhoory teaching hospital, mosul medical city, from november 2007 to november 2008 included 60 female patients with palpable breast masses, their age ranging between (20-76) years, were assessed prospectively using triple assessment modalities and the results of each modality were classified as benign, suspicious or malignant and compared with the confirmatory histopathological examination of the tissue specimens obtained from all patients under study via an appropriate surgical procedure. the data was collected, classified and analyzed. RESULTS: The results triple test (TT) was concordant (elements had either all benign or all malignant) in 31 cases (52٪) with diagnostic accuracy reaching (100٪). Again the TT achieved (100٪) diagnostic accuracy when all elements were either malignant or suspicious which appeared in 12 of 29 nonconcordant cases (20٪ of all cases). FNAC was the most reliable element of TT in cases where the elements of TT weren't concordant (NPV 94.5٪, sensitivity 92٪ and accuracy 96.7٪). CONCLUSION: The TT has proved to be accurate, reliable diagnostic approach for evaluation of breast masses, achieved (100٪) accuracy rate when all elements were concordant or when all elements were either suspicious or

Role of fine needle aspiration cytology in evaluating the Breast Lumps

Abstract: Background: Fine needle aspiration cytology is an evaluation tool for the breast lumps. This study was conducted to evaluate the results of fine needle aspiration cytology in comparison with open biopsy. Material & Methods: This was a comparative study conducted at Saidu Teaching Hospital, Swat, from July 2007 to December 2010. Total 210 patients were included in the study, who presented with breast lump to outpatients department. Fine needle aspiration cytology and open biopsy (excisional/incisional) were performed simultaneously under local or general anesthesia. Results: The diagnostic yield of fine needle aspiration cytology was 95.2% (200/210 cases) accurately diagnosed compared with results of open biopsy 100%. The results of 3 cases were suspicious and 7 were unsatisfactory on fine needle aspiration cytology. Conclusion: Fine needle aspiration cytology is a sensitive and specific test for evaluation of the breast lumps. It should be the first line investigation in evaluating the breast lumps.

Spontaneous Infarction of Fibroadenoma of the Breast in a Young Girl Mimicking Carcinoma

Abstract: Spontaneous infarction is an uncommon complication of fibroadenoma of the breast. Although infarction following fine needle aspiration (FNA) has been reported in the literature, infarction encountering on first time aspiration is very rare. Lack of knowledge of this entity may lead to an erroneous diagnosis of inflammatory lesion like mastitis and carcinoma on cytology smears.We report the cytological and histological findings in partial spontaneous infarction of fibroadenoma in an 18-year-old female and literature reviewed. In young patients with breast lumps, if the aspirated material is necrotic, the probable diagnosis of spontaneous infarction should always be kept in mind. Viable fibroadenomatous tissue should be searched for in the FNA smears.

Approach to the diagnosis of a breast lump

Abstract: Patient complaints of breast lumps or lumpiness are common, ranging from 40% to 70% in women seeking advice. A breast lump, either self detected, screen detected or clinician detected, raises the fear of breast cancer in any woman, irrespective of age. Fortunately, the vast majority of breast lumps are benign, but this does not negate the need for evaluation of any palpable breast lesion. Failure to diagnose breast cancer accounts for the most frequent and expensive claims brought against physicians. Public education about breast cancer has heightened awareness regarding breast health, and it is anticipated that an increasing number of women will present for the evaluation of breast masses.

Observations on the Therapeutic Effect of Acupoint Application of Chinese Herbal Medicine on Hyperplasia of Mammary Glands

Abstract: Objective To compare the clinical efficacy of acupoint application of Chinese herbal medicine with oral administration of prepared Chinese herbal medicine "Rupixiao" in treating hyperplasia of mammary glands.Methods Ninety patients with hyperplasia of mammary glands who had regular menstruation were enrolled and allocated to two groups.The treatment group of 60 cases received application of Chinese herbal medicine at mammary Ashi point and point Shenque and the control group of 30 cases took prepared Chinese herbal medicine "Rupixiao" orally.Breast pains,breast lumps,Breast imaging reporting and data system(BI-RADS) grades,adverse effects and clinical therapeutic effects were compared between the two groups.Results Breast pains were relieved,the size of the lump decreased and the range of lump distribution reduced(under color ultrasonography) in both groups after treatment.There were statistically significant differences(P0.05).The BI-RADS grade decreased markedly in both groups of patients(P0.05).The total efficacy rate was 96.7% in the treatment group and 93.3% in the control group.No severe general adverse reaction occurred in both groups during treatment.Of the treatment group,a local itch occurred in 1 patient and skin redness in 2 patients.Conclusion Acupoint application of Chinese herbal medicine can remove or relieve breast pains,reduce breast lumps and the range of their distribution,decrease the BI-RADS grade and improve the therapeutic effect on hyperplasia of mammary glands.The therapy produces less adverse reactions and is convenient for patients to use.

To evaluate the accuracy of FNAC in palpable breast lumps at Breast Clinic of Abbasi Shaheed Hospital, Karachi

Abstract: Objective: To evaluate the accuracy of FNAC in palpable breast lumps at breast clinic of Abbasi Shaheed Hospital, Karachi. Study design: Th is was a prospective study. Sett ing and Duration: Abbasi Shaheed Hospital, Karachi Medical and Dental College from Jan 2002 to Dec 2002. Methodology: Consecutive 60 female patients with palpable breast lumps were studied. Th ey included 21 malignant and 37 benign lesions. Result: A comparison with histopathology shows sensitivity of 91.3%, specifi city and positive predictive value of 100%. Diagnostic accuracy was 96.5% with no false positive and 2 false negative results. Conclusion: Fine Needle Aspiration Cytology can be used as a diagnostic procedure in combination with clinical and radiological assessment to evaluate the breast masses and routine biopsy can be reserved to the lesions where Fine Needle Aspiration Cytology is not conclusive.

Management of benign diseases of the breast

Abstract: The majority of lesions that occur in the breast are benign. Despite this they are a major cause of concern of anxiety and morbidity to patients. It is important to recognize symptoms and signs, to exclude malignancy and manage appropriately. Breast lumps, nipple discharge, mastalgia, breast infection and gynaecomastia will be reviewed.

Non-conventional hormone therapy - Tissue-specific Tibolone-Caution.

Abstract: Objectives: The present retrospective study was undertaken to assess safety profile of long term Tibolone therapy when one of my patients developed carcinoma breast. Methods: Fifty patients who were put on Tibolone were studied as regards the indication for Tibolone therapy, age distribution, duration of therapy and side effects. Results: Although most subjects responded well to therapy without significant side effects two patients developed breast lump. One of the breast lumps was malignant, the other benign. It is possible that prolonged Tibolone therapy may have caused carcinoma breast as against the notion that Tibolone is breast protective. Few of recent studies like Million Women Study and LIBERATE study which was concluded in April 2010, have shown that Tibolone also increases risk of carcinoma breast. Conclusion: Tibolone when used for management of menopausal symptoms should be given for less than 4 years and regular follow up with mammography is must.

Body surface localizing membrane for breast lumps

Abstract: The utility model provides a body surface localizing membrane for breast lumps, which is characterized by comprising a membrane, a round hole is arranged at the center of the membrane, and scale marks and concentric circles are arranged on the membrane. The body surface localizing membrane for breast lumps has the advantages that examination results from clinical doctors and sonographers are marked on the same membrane which is convenient for comparing two examination results and observe variation of lumps in a follow-up manner after medicine treatment. Therefore, the localizing membrane is simple in design, accurate in measurement, convenient in operation, low in cost and suitable to be popularized.

Method of Breast Lumps Segmentation Based on Immune Algorithm and Level Set

Abstract: This paper proposes an automated breast lumps segmentation method.First,according to the features of lumps,such as local high intensity and local uniformity,an immune algorithm based detector is used to find the region of interest(ROI) quickly,and the non-object area of ROI is reduced remarkably.Second,C-V level set model is employed to segment the ROI more precisely by setting the initial level set automatically.The method not only improves the performance and the extent of segment automation,but also enhances the truth that the object and the background are homogeneous.Experiments show that the method can segment lumps automatically,rapidly and correctly,even if a lump is spiculate.And the segment results are in agreement with the radiologists' opinions.