Showing papers on "Breast lumps published in 2023"

Role of magnetic resonance imaging in the evaluation of non-palpable breast masses

Abstract: Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) provides anatomical and functional information with high sensitivity and variable specificity, making it a useful tool in the detection of breast cancer. The noninvasive functional imaging method known as diffusion-weighted imaging (DWI), sensitive to tissue microstructure and cellularity. The aim of this work was to assess the role of DCE-MRI and DWI in the evaluation of non-palpable breast masses. Methods: Fifty female cases participated in a prospective research who were suspected to have non-palpable breast masses accidentally discovered or suspected by ultrasound and referred to MR units. All cases were subjected to complete personal and medical history, full clinical examination, laboratory investigations, mammogram and breast ultrasound and breast MRI. Results: DCE-MRI could predict non-palpable malignant lumps with 89.66% sensitivity, 95.24% specificity, 96.30% (PPV), 86.96% (NPV) and 92% accuracy. MRI could predict non-palpable benign lumps with 90.48% sensitivity, 96.55% specificity, 95% (PPV), 93.33% (NPV) and 94% accuracy. DWI could predict malignant masses with 93.10% sensitivity, 71.43% specificity, 81.82% (PPV), 88.24% (NPV) and accuracy 84%.Conclusions: DCE-MRI outperformed DWI-MRI in diagnostic performance; however, DWI-MRI still demonstrated good diagnostic performance with a 93.1% sensitivity and specificity of 71.4%. Both are excellent non-invasive techniques that are very useful in assessing non-palpable breast masses.

An Atypical Presentation of Superficial Breast Cancer: A Case Report and Review of the Literature

Abstract: (1) Background: Retroareolar breast tumors, although common, rarely develop into malignancies. This case report presents the case of a 54-year-old woman with a superficial breast tumor, high-lighting the significance of considering a wide range of possibilities when evaluating breast lumps. (2) Methods: The patient presented with a progressively enlarging, ulcerating superficial mass in her left breast. To determine the nature of the tumor and results confirmed the presence of a Grade II superficial infiltrating ductal carcinoma. To address the condition, the patient un-derwent a modified radical mastectomy under general anesthesia. Following the surgery, she was prescribed tamoxifen, an estrogen receptor modulator, in accordance with the current guidelines. (3) Results: The patient experienced a smooth recovery without any complications and displayed no signs of recurrence or metastasis during follow-up visits. This positive outcome highlights the importance of early detection and proactive management in improving patient prognosis. (4) Conclusions: This case report underscores the significance of conducting a comprehensive ex-amination and maintaining a high index of suspicion for breast lumps. This report contributes to the existing body of literature on the diverse presentations of breast cancer.

A Panoramic View of Morphological Spectrum of Male Breast Lesions at a Tertiary Care Hospital in South India

Abstract: Abstract Background : Though male breast lesions are infrequently studied and documented, a wide variety of lesions afflict it. Conditions and entities that affect the female breast also occur in the male breast. However, lobular lesions are seldom seen in male breasts because of absence of terminal differentiation induced by progesterone. So far, there have been very few studies on the spectrum of male breast lesions and most of them are done either on aspiration smears or on biopsies. Therefore, in the present study, we aimed to analyse the spectrum of different types of male breast lesions at our tertiary care centre both on aspiration cytology smears and histological specimens as well as biopsies. Objectives : To study the spectrum of male breast lesions encountered in histopathology and cytology lab. Study Design: Data on male breast lesions between 2010 to 2015 were retrieved from the records of Kasturba Medical College, Mangalore. The cytological and histological features were studied and the number of benign and malignant cases recorded. Cytohistologic correlation, wherever available was done. Immunohistochemistry was studied in malignancies wherever available. Results : Out of 7700 breast lumps retrieved, 120 (1.55%) male breast lesions were identified. Of these, 54 were diagnosed by FNAC and 76 lesions on surgical specimens. On FNAC, 49 were benign and 5 malignant. The 76 cases diagnosed on histology had 70 benign and 6 malignant lesions. The benign lesions were gynecomastia, inflammatory masses, fibroadenoma and intraductal papillomas. Malignant lesions included infiltrating ductal carcinoma (NOS), papillary and metastatic carcinoma with 60% showing ER positivity. Ten of these cases had both cytology and histology. Conclusion : While gynaecomastia and invasive ductal cancer were the commonest lesions encountered in the male breast, there were other rarer benign and malignant lesions.

Benign and malignant breast diseases during pregnancy and lactation: a diagnostic challenge.

Abstract: OBJECTIVE To determine the frequency of breast cancer associated with pregnancy and lactation, and to evaluate the lesions on ultrasound. Methods The descriptive, observational study was conducted at the Dow Institute of Radiology, DUHS, Karachi from December 2020 to August 2021, and comprised of pregnant and lactating women with clinically palpable breast lumps and/or painful breast. The margins, orientation, echo pattern and associated features of the lesions were studied on ultrasound and were assigned a Breast Imaging Reporting and Data System grade. All the lumps were followed and ultrasound-guided core needle biopsy for histopathology was done of grades IV and V cases. Incidence and Accuracy of ultrasound for diagnosis of pregnancy-associated breast cancer was estimated. Data was analysed using SPSS 26. RESULTS Of the 237 women, 19(8%) were pregnant and 218(92%) were lactating. The overall mean age was 28.4±5.5 years. Ultrasound findings for lactating and pregnant women were significantly different (p=0.05). Significant association of Breast Imaging Reporting and Data System grades III, IV and V lesions with heterogeneous echo texture of mass was seen (p<0.001). Biopsy was performed in 20(8.4%) cases, and 12(60%) of them had benign results on histopathology. CONCLUSIONS A variety of benign and malignant breast diseases were found in women during pregnancy and lactation phases.

Analysis of histopathological findings of breast biopsies at a tertiary care centre

Abstract: Background: In India, breast cancer has become a leading cause of cancer death. The indication of a breast lump can be cause of great concern in most patients. While most of the lumps are benign in nature, there is a possibility of an increased risk of developing premalignant lesions. Any breast mass/lump requires histological diagnosis to get a clear picture of the lump associated problems. Methods: This is a retrospective, descriptive and a cross-sectional study of all the patients with breast lumps seen in Bhaktivedanta Hospital and Research Institute from January 2018 till March 2022. Histopathology reports of breast biopsies of patients required at Bhaktivedanta Hospital and Research Institute were included in the study. Results: The total number of cases of breast biopsies available were 449. These cases are grouped into benign and malignant cases which comprise of 276 (61.47%) and 173 (38.53%) cases respectively. The most common benign diagnosis observed was fibroadenoma which accounted for 184 (66.67%) cases. Based on age grouping, the 21-40 age group contained the maximum number of benign cases. The most common malignancy observed was of ductal carcinoma with 163 (94.21%) cases. Based on age grouping, the age group of 41-60 contained the maximum number of malignant cases. Conclusions: It is imperative that all breast lesions should undergo biopsies irrespective of clinical findings for the following reasons: rising incidence of breast cancer, to rule out/confirm malignancy and to complete the diagnostic triad of clinical diagnosis, radiology and pathology.

Mammary Myofibroblastoma in a Male: A Case Report and Review of the Literature

Abstract: Mammary myofibroblastoma is a rare benign tumor. It is mainly seen in older men and postmenopausal women. These tumors can be presented with a palpable mass or can be discovered incidentally on routine screening. A 76-year-old male presented with a palpable breast mass that was increasing in size. The patient underwent wide local excision with no postoperative complications. The pathology finding was consistent with myofibroblastoma. Myofibroblastoma is a rare tumor and should be considered one of the differential diagnoses in breast lumps.

Cytomorphological patterns of breast lesions among women with palpable breast lumps attending select teaching and referral hospitals in Kenya: a descriptive cross-sectional study

Abstract: Introduction breast lumps account for a greater number of lesions in women attending surgical clinics in the developing world. Breast cancer which mostly presents as a breast lump is the leading cancer in Kenya, with an incidence of 12.5%. The study aims to describe the patterns of breast lesions in women presenting with palpable breast lumps in two major referral hospitals in Kenya. Methods seven hundred and sixty-eight study participants with palpable lumps underwent fine needle aspiration cytology (FNAC). Sociodemographic data were captured using structured questionnaires. The FNAC materials were evaluated using the International Academy of Cytology Yokohama System (IACYS) and the lesions were classified into five-tier categories. Frequencies and percentages were used to summarize qualitative variables. Results of 768 smears, 84.8% (n=651) were adequate for evaluation while 15.2% (n=117) were inadequate. Neoplastic lesions comprised 84.5% (n=550) and non-neoplastic 15.5% (n=101). Benign lesions accounted for 83.6% of the lesions followed by breast carcinoma (10.4%). Ductal carcinoma comprised 98.5% of cancerous lesions. The age group most affected with ductal carcinoma and suspicious lesions was 20-34 years (37.3% and 55.6% respectively). Fibroadenoma formed the bulk of the benign lesions identified (44.1%). Suspicious of malignancy was 4.1% (n=27). The age group with the most lesions (47.5%) was 20-34 years. Conclusion a wide spectrum of breast lesions was established. Such include inflammatory, atypical, benign, suspicious of malignancy, and malignant lesions. Fibroadenoma was a common lesion diagnosed. The age group most affected by malignant lesions was 16-49 years, necessitating enhanced screening of women with breast lumps in our setups.

Incidence of breast nodules in young women from 15 to 35 years: a literature review

Abstract: Nodules are tumors that may present cystic or solid content. That benign mammary feature constitutes up to 80% of all palpable lumps existent in women. Among these nodules, fibroadenoma is the most common in women aged between 15 and 35 years old. Thus, it's important for the scientific community and the population to the study parameters, such as the growth of young people that presents mammary nodules, the risk factors, the most frequent types in young women, as well as the diagnostic description. This study has an exploratory qualitative approach, done through an integrative revision of the scientific literature available in Portuguese and foreign languages from 1988 to 2020 about mammary nodules in young women. The importance of carrying out this research is justified by the analysis of the mammary nodule incidence in young women over the years, and thereat verify if there were precursor wounds of mammary cancer. Therefore it is possible to find if there is an increase in its incidence and perform an early diagnosis to attend to the antecedence of the symptoms of this benign disease. In addition, if there is a history that biases the increase of cancer risk in the future, it's possible to prevent it based on the identification of high-risk lumps. This topic has an authentic profile, with no referent article, and has not been discussed in the existent platforms, so it makes this relevant and innovative

Frequency of breast cancer in palpable breast lump

Abstract: Background: Breast cancer is one of the most common types of cancer in women. In the past few decades, its prevalence has increased exponentially. Aim: To evaluate the frequency of breast cancer in our setup. Method: A descriptive cross-sectional study was conducted at K.V.S.S. SITE Hospital, Karachi for the period of 6 months from January 2022 to June 2022. The sample size for this study was 95 patients.The tru-cut biopsy was performed, using a tru-cut gun on patients with BI-RADS 3 clinically suspicious and family history positive.The data obtained was analyzed on the latest version of the SPSS Statistics version 26 (IBM Corp., Armonk, NY, USA). The frequency and percentages of the categorical variables were calculated. Result: A total of 95 female patients presented with palpable breast lumps. The age group presented most commonly with the lump was 32-42 years (40%).The variables like smoking, drinking, raised BMI, history of any cancer, family history of breast or any other cancer, and oral contraceptive use were found to be statistically significantly associated with the malignancy related to the breast (p <0.001). Practical implicaion: This study provides the incidence of the breast cancer which will help the doctors assess every women presenting with the breast lump and provide the required treatment early so that worst outcomes can be avoided. Conclusion: The palpable breast lump should be assessed on an immediate basis and further workup should be conducted in such patients for early diagnosis and improved treatment of the breast cancer. Keywords: Breast lump, Breast cancer, Breast biospy, frequency of breast lump, young women, family history

Pattern of Various Male Breast Diseases in a Tertiary Care Centre of Aurangabad District, Maharashtra, India- A Prospective Interventional Study

Abstract: Introduction: A small percentage of men are affected by breast diseases and awareness of male breast disease is less and presentation is often delayed due to embarrassment. The most common presentation is gynaecomastia, where cosmetic correction is sought. Over the last two decades the rate of male breast complaints increased from 0.8% to 2.4%, while 1% of all breast cancer occur in males. Aim: To study the pattern of various male breast diseases in a tertiary care centre of Aurangabad District in Maharashtra, India. Materials and Methods: This prospective clinical interventional study was carried out in 44 male patients above age of 12 years coming with complaints related to breast to Department of General Surgery of Government Medical College, Aurangabad from 1st August 2017 to 31st July 2019. Detailed history was taken and any underlying causative disease/risk factor or medication if any was noted. Thorough clinical examination and laboratory investigations were done. Ultra-sonography of breast was done in all patients. Mammography was done in three patients who were having clinical suspicion of malignancy. Continuous variables were presented as mean, Standard Deviation (SD) or median if the data is unevenly distributed. Categorical variables are expressed as absolute numbers and percentages. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 17.0. Results: The youngest patient was 12 years old and eldest was 85 years old. In the present study, 38 benign and 6 malignant male breast diseases were diagnosed. Out of total, 33 had gynaecomastia, 2 had breast abscess, 5 Infiltrating duct carcinoma and 1 each of mastitis, eczema of nipple, sebaceous cyst of areola and primary breast sarcoma. Out of 44 patients, 12 patients underwent surgery for benign and malignant breast diseases, 24 patients of gynaecomastia were managed by reassurance, 5 males with infiltrating ductal carcinoma were managed by modified radical mastectomy and 3 patients by medical therapy. Conclusion: It was concluded that benign male breast diseases were more common and ultrasound together with mammography should be used to differentiate characteristics of benign and malignant male breast lesions.

Spectrum of breast diseases in North Western India: an analysis of 8604 pathologies

Abstract: Background: There is paucity of data on the spectrum of breast diseases in India due to lack of reporting system. This study was conducted to understand the pattern of breast diseases in northwest India. It is by far the largest study to provide epidemiological data on breast disease spectrum in India. Methods: Total of 8604 breast pathological reports were obtained from four major diagnostic centers in North West India. These included benign and malignant breast lesions. Results: There were 5985 (69.56%) lesions in the benign group and 2619 (30.43%) lesions in malignant group. Women formed 92.73% (7978) of the study group. Among benign lesions, most common were discrete benign lumps 59.19% (3543) followed by fibrocystic changes 16.02% (959). The most common age group was ≤20 years for discrete benign lumps and gynecomastia whereas 31-40 years for fibrocystic changes. Among malignant lesions, the most common was infiltrating duct carcinoma (not otherwise specified) with 32.72% (857) followed by infiltrating duct carcinoma (moderately differentiated) 26.84% (703) with the most common age group of 41-50 years. Among breast lesions in men, male breast carcinoma formed 2.25% (59) of malignant breast lesions. Gynecomastia formed 0.65% (560) of all breast lesions. Conclusions: Most common breast lesions were discrete breast lumps. Benign lesions are more common in early 20’s while malignant lesions are more common in the 5th decade. The study revealed a higher proportion of male breast carcinoma.

Comparison of cytological and histopathological findings in breast lesions – a tertiary care center

Abstract: Introduction: The objective of the study was to compare the findings of cytological and histopathological features of breast lesions. Methods: This study conducted on 109 patients with breast lump with fine needle aspiration cytology (FNAC) followed by histopathology at Department of Pathology, Pacific Institute of Medical Sciences, Umarda, Udaipur, Rajasthan. The study duration is 18-month study period (April 2021 to September 2022). Results: The mean age of the study subjects was 44.20 years with majority of the patients belonged to the age group 41–50 years (36.70%). Out of 109 cases, 84 cases (77.07%) were benign and 23 cases (21.10%) were malignant pathology in FNAC. Rest two cases had intermediate pathology. Majority of histopathological diagnosis of breast lumps in the present study were benign pathology (75.23%) and rest all malignant (24.77%). Conclusion: Our study shows that FNAC can reliably distinguish between benign and malignant conditions and it is a sensitive and specific modality that assist in diagnosis and management of breast lesions. Although FNAC has been found to be a most valuable economic, simple, and safe diagnostic procedure, due to certain pitfall of FNAC like in case of pauci-cellularity blood mixed aspirates and blind technique procedure. Histopathological correlation is always mandatory for early diagnosis and better prognosis.

Knowledge regarding breast self-examination among middle aged women of Uttarakhand

Abstract: Background: Breast self-examination involves the women herself looking at the mirror and feeling each breast for possible lumps and distortion or swelling. It is seen that more than 10% to 20% breast cancer is detected by breast self-examination. Methods: A descriptive cross-sectional study was conducted to assess knowledge regarding breast self-examination among middle aged women in a selected community setting of Uttarakhand. A total of 62 samples were selected through systematic randomized sampling technique. A structured knowledge questionnaire was administered through interview technique to assess the knowledge. Results: Most of the (49%) women had poor knowledge regarding breast self-examination. There was significant association between age of the samples, education status, family income and previous information regarding breast self-examination with knowledge score. Conclusions: The study concluded that there was inadequate knowledge regarding breast self-examination among middle aged women in Uttarakhand. There is a need for educational programs to create awareness and improve knowledge regarding routine breast self-examination.

Utility of fnac in the evaluation of breast lesions with histopathological correlation

Abstract: Introduction: Most of the women with breast pathology present as lump in their breast. Malignancy of Breast is the most common problem with increasing incidence in females. Early diagnosis and appropriate treatment of a breast lump is lifesaving. Fine-Needle Aspiration Cytology (FNAC) is a simple, safe, inexpensive method with wide acceptance and used as a rst-line diagnostic procedure for diagnosis of breast lesions. The main aim of the study w Aim: as to diagnose any palpable lump of the breast in females by FNAC technique and to correlate with histopathology reports. This was a retrospe Setting and Design: ctive study done out in the Department of Pathology, Kurnool Medical College, Kurnool. Study period was for 2 years (January 2021 to De Materials and Methods: cember 2022). For all breast lumps FNAC was done, processed; Haematoxylin and Eosin stain and Papanicolaou stain was done wherever necessary. For same patients who ever undergone Tru-cut biopsies, excisional biopsies, and surgical specimens were received and histopathological correlation was done. Data was collected and entered in MS excel sheet. The sensitivi Statistical Analysis: ty, specicity, positive predictive value, negative predictive value, and accuracy were calculated. Among 531 cases, 426(80.22%) were benign Results: and 105(19.77%) were malignant on cytology. Out of this, 215(40.48%) cases underwent histopathological examination, in which 118(54.88%) were benign and 97(45.11%) were malignant cases. The sensitivity, specicity, positive predictive value, negative predictive value, and accuracy of the present study were 84.82%, 98.05%, 97.93%, 85.59%, and 91.96% respectively. The FNAC is the common and most important prelimi Conclusion: nary diagnostic test in palpable breast lumps and there was high degree of correlation with a nal histopathological report

Role of Triple Test in Evaluating Breast Lumps

Abstract: Breast tissue undergoes constant physiological changes in a woman’s life because of influence of endocrine hormones during and after reproductive life. These changes may present as pain, lumpiness or both in the breast. Breast lumps are feared for cancer. Thus, it is important for women with a breast lump to receive appropriate evaluation. Clinical breast examination is first step in evaluation of breast lump. The diagnostic sensitivity of clinical breast examination is high (98%) whereas its specificity is low, averaging 48%. Ultrasound is preferred in evaluation of radiologically dense breasts and in the study of breasts with augmentation mammoplasties. Micro-calcifications on mammography are considered to be important signs of breast cancer. X-ray mammography detects microcalcifications in 30–50% of breast cancers. FNAC is a cheap, cost effective and readily available routine diagnostic with a sensitivity ranging between 89% to 98% and specificity between 98% to 100% for palpable breast lumps. When combined together triple test achieves a higher sensitivity, specificity and diagnostic accuracy than any of the investigations taken alone. We conducted a prospective study to evaluate breast masses by clinical assessment, imaging and pathological examination. Results were compared with histopathology. We concluded that triple assessment in breast lumps gives superior results than any of its modalities taken alone.

A clinicopathological study of non neoplastic and neoplastic breast diseases and its correlation with radiological diagnosis

Abstract: Objectives- 1) To study the various modes of clinical presentation, etio-pathogenesis of non- neoplastic and neoplastic breast diseases. 2) Comparing with the FNAC and radiological diagnosis. Methods- 60 female patients with lump in the breast were taken for the study. After clinical diagnosis it was cross checked with radiological diagnosis and FNAC. The excised specimen was sent for Histopathological examination and results were compared with clinical diagnosis, cytological diagnosis, and radiological diagnosis. Accuracy and predictive values were calculated out of the results. Results: Out of 60 patients, 39(65%) breast lumps were benign & rest 21 lumps (35%) were malignant and most were seen in upper inner quadrant, whereas majority of the carcinoma breast were found in upper outer quadrant. Fibroadenoma, seen in the second decade, was most common lesion accounting for 48.3% (29 lesions) and all were diagnosed clinically and on USG and were conrmed on HPE. Breast carcinoma was second common, 35% (21 lesions). Maximum number of Carcinoma breast cases were in 5th and 6th decade, 20 out of 21 (96%). Out of 2 and 4 cases of brocystic disease and phyllodes respectively, one case in each was found to have carcinomatous changes on HPE. Conclusion- Breast lump was the most common presentation in this study for both benign and malignant lesions. Diagnostic accuracy of broadenoma by FNAC and USG is 100% in this study. Diagnostic accuracy of carcinoma breast by FNAC and USG is 90.4% in this study. PPV of overall breast lumps is 96.6% with both FNAC and USG. For carcinoma breast the PPVis 100% with both FNAC AND USG. Lymph node were detected Signicantly by using USG, in a clinically non palpable axillary lymph nodes which helped in the further appropriate management

Frequency of Clinically Palpable Breast Lumps in an Urban Medical Center Importance of a Surgeon Run Breast Clinic

Abstract: The study of breast diseases and their epidemiology deserves special attention. Another reason that grants special value to the breast diseases is the way it affects women health both physically and mentally. The commonest breast symptom is breast lump. Breast lumps are the most common symptom bringing patient to a breast clinic. They are also the most common cause of serious trouble for the patients keeping in view the increased incidence of breast cancer. This is partially due to increased awareness among females. In this study we detected the frequency of clinically palpable breast lumps and their causes and treatment presenting to the breast clinic of a busy private sector hospital. Methods: Study design: Descriptive case series Place of study: Department of Surgery, Holy family Hospital Karachi Duration of study: 1 year (from July 2020 till June 2021) Study population: All females presenting to the breast clinic within the mentioned period Data collection procedure: All the information was taken by the patient through history. Informed consent was taken for examination. Further investigations according to the triple assessment protocol were done in patients who presented with a lump to ascertain the exact nature and etiology of lump. All the data was then entered in a predesigned proforma. Results: A total of 126 patients presented to the breast clinic in Holy family Hospital. The number of patients presenting with breast lump was just above half of the total patients i.e 66 patients (52%).Out of these 66 patients, majority was benign i.e 53 patients(80%) with malignant lumps accounting for 13 patients,20 % of the total patients with breast lump.60(48%) patients presented with symptoms other than breast lump. The most common symptom other than lump was pain followed by nipple discharge, skin diseases etc. Conclusion: Breast lump was the most common symptom in patients presenting to our breast clinic and majority were benign and did not require surgery. Keywords: Clinically Palpable, Breast Lump, Triple Assessment

Comparative Accuracy and Complications of Palpation-Guided Versus Ultrasound-Guided Core Needle Biopsy of Palpable Breast Lumps in Ahmadu Bello University Teaching Hospital, Zaria

Abstract: Background: Breast lumps are a common complaint by women. Palpable breast lumps are accessible to core needle biopsy (CNB) with the aim of obtaining tissue for histologic diagnosis. CNB is achievable either by palpation guidance or image guidance. The superiority of either technique in returning an accurate diagnosis has not been demonstrated in our centre. Aim: This study aimed to compare the diagnostic accuracy and complications of palpation-guided versus ultrasound-guided CNB techniques in palpable breast lumps. Materials and Methods: This was a randomised, controlled, comparative study. Consenting patients were randomised into either a palpation-guided or an ultrasound-guided group. All patients subsequently had open surgical biopsy, which represented the control group. Data analysis was done using SPSS, version 21. Results: Each CNB group had 40 patients. In the palpation-guided group, 24 (54.55%) lumps were benign and 13 (29.55%) were malignant, whilst seven (15.90%) were inconclusive. In the ultrasound-guided group, 31 (65.96%) lumps were benign and 15 (31.91%) were malignant, whilst one (2.13%) was inconclusive. The sensitivity and specificity for palpation-guided CNB were 92.9% and 100%, respectively. The sensitivity and specificity for ultrasound-guided CNB were 100% each. There was no statistically significant difference in sensitivity between the two groups (P value of 0.4828). One patient (2.5%) in the ultrasound-guided CNB group had a hematoma. Conclusions: This study has shown that CNB has high diagnostic accuracy and low complications in the management of breast lumps, either by palpation-guided or ultrasound-guided techniques. There was no significant difference in accuracy or complications of CNB using either technique.

Granulomatous mastitis – An uncommon finding

Abstract: A 19-year-old female came with complaints of multiple lumps in her right breast of different sizes, which she had noticed one month back. The woman also gave a lactating history and family history of tuberculosis. After obtaining informed consent from the patient, minimally invasive procedure, Fine Needle Aspiration Cytology (FNAC) was performed and about 2 ml of pus like material was aspirated. Giemsa stained microscopic finding showed epithelioid cells along with lymphocytes in a necrotic background that were consistent with Granulomatous mastitis. Sometimes epithelial atypia can be worrisome in cases of mastitis. Hence clinical correlation is necessary along with cytological findings for interpretation. Open biopsy is the gold standard for definitive diagnosis.

Anthropometric variables in breast lesions of women of reproductive age in university of port harcourt teaching hospital

Abstract: Background. Benign breast diseases are a potential health concern to a large number of women. The incidence of cancer is increasing worldwide. A steady increase in incidence has been observed in most developed and developing counties. Objective. Thus, our study seeks to investigate the anthropometric variables implicated in breast lesions of women of reproductive age. Methods. This is a descriptive and prospective study with a random sampling method; the data was obtained from the Department of Surgery, Radiotherapy and Oncology Unit of University of Port Harcourt Teaching Hospital. A total number of 146 subjects (18-49 years) were involved into this study. A number of 90 were breast lump patients and 56 were breast cancer patients. Results. Data obtained was analysed with Microsoft Excel. Our results show no statistically significant difference (P> 0.05) in the body mass index (BMI) and waist-hip-ratio (WHR) of both the breast lump and breast cancer patients. This study supports the fact that high BMI is a predictive marker for breast lumps and cancer in women. Conclusion. The study has also identified that high BMI favours the incidence of breast lumps and breast cancers in women of reproductive age.

Cytomorphological overview of fine-needle aspiration breast utilizing the International Academy of Cytology – Yokohama system of reporting

Abstract: Background: Benign and malignant lesions of breast are one of the most common causes of palpable masses seen in women. Fine-needle aspiration cytology (FNAC) is the important modality of diagnosis of breast lumps. Previously, there were no uniform criteria for reporting breast FNAC. To overcome this problem, the newly designed system – International Academy of Cytology (IAC) – Yokohama system of reporting was implemented in 2016. The system offers a structured report to the patient. Aims and Objectives: This study aims to categorize breast FNAC according to the IAC – Yokohama system of reporting, to calculate the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of the test, and to analyze the cytomorphological spectrum of various breast lesions. Materials and Methods: A total of 210 patients presenting with breast lump in cytology section were subjected to FNAC using a 22 gauge needle under all aseptic precautions. Detailed clinical history was taken. All cytology and histopathology examination slides (wherever available) were thoroughly studied. FNAC smears were reported using IAC – Yokohama system of reporting. Results: In our study, benign category (C2) was most commonly seen in 73.33% of cases, followed by 10.48% of cases of atypical probably benign (C3), 2.38% of cases were reported as suspicious (C4), and 11.43% of cases were reported as malignant (C5). Cytohistopathological concordance was seen in 38 cases (88.4%) whereas five cases were reported as discordant. Sensitivity and specificity of the test for the diagnosis of malignancy were 81% and 100%, respectively. PPV was 100%. NPV was 90.90%. Diagnostic accuracy of the test was 93.47%. Conclusion: The newer IAC – Yokohama system of reporting of breast FNAC is simple, has clear diagnostic criteria hence boost up the confidence as well has uniformity of reporting by cytopathologist, and increases the understanding and uniformity in assessment by the attending clinician which help in improving the communication between the pathologist and the treating clinician.

Characterization of lesions of the Breast by using diagnostic imagining Technique: Ultrasound Elastography

Abstract: Objective: To measure the diagnostic accuracy of Ultrasound Elastography in the differentiation of benign and malignant breast lesions from each other by simultaneously doing confirmation through histopathology of breast lesions. Study Design: Cross-Sectional study. Place and Duration: Department of Radiology, Mardan Medical Complex Hospital from June 1st, 2020 to December 1st, 2020. Methodology: Patients who presented with breast lumps were included. Patients with cystic breast lesions, those who had had surgery or chemotherapy, and those who had signs of infection were all excluded from the study. After Ultrasound elastography evaluation of lesion, the results were compared with the histopathology of the lesion post-operatively. The diagnostic accuracy of ultrasound elastography were analyzed. Results: The total f 165 women studies, with an average age of 45.4+10.5 years (range 34-56). The mean elastography value for benign lesions was 48.96kPa+42.32 and for malignant lesions was 132.78kPa+42.32 (P 0.001). Malignant lesions found on ultrasound elastography were 117 among 165 (71%) patients. Benign lesions of the breast were 48 among 165 patients (29%). When confirmed with histopathology, 122 patients (73.93%) were found to have malignant breast lesions in 165 patients while 43 had benign lesions (26.06%) which proved breast elastography has high diagnostic accuracy. The mean elastography value for benign lesions was 48.96kPa+42.32 and for malignant lesions was 132.78kPa+42.32 (P0.001). Conclusion: Breast elastography imaging method minimize the frequency of biopsies of breast lesions conducted by pathologists saving cost and decrease suffering of patients and high diagnostic accuracy for breast elastography was observed. Keywords: Breast, Benign Lesion, Malignant Lesion, Mammography, Ultrasound Ultrasonography, Histopathology How to Cite This: Baiq H, Begum T, Akram R, Haq MU, Afridi SQ. Characterization of lesions of the Breast using diagnostic imagining Technique Ultrasound Elastography. Isra Med J. 2022; 14(3): 117-120.DOI: https://doi.org/10.55282/imj.oa1315

Comparative Evaluation of FNAC and USG Breast with Core Needle Biopsy in the Diagnosis of Malignant Breast Lesions: A Prospective Observational Study

Abstract: Background: There is no doubt that breast cancer is the most frequently diagnosed life-threatening cancer in women and a significant cause of cancer death among women in both developing and developed nations. Using breast imaging-reporting and data system (BI-RADS) classification and breast core needle biopsy (CNB) results, we compared the diagnostic efficacy of FNAC and ultrasonography breast in separating malignant from benign breast masses. Methods: After getting the approval from the Institutional Ethical Committee, the present prospective cross-sectional study was conducted in the Department of Pathology, Government Medical College, Srinagar (tertiary care hospital), Kashmir, India over a period of 2 years (July 2019 to June 2021). Results: With a mean age of (45.4±13.4) years, the age incidence among the 108 individuals ranged from 22 to 85 years, with the most common age group for breast lumps to occur being (30-39) years. Both FNAC and USG breast were compared to CNB (gold standard), they both had sensitivity and specificity values of (94.57%, 100%) and (95%, 50%), respectively. Conclusion: When FNAC and USG breast were compared to CNB, the gold standard test, FNAC was found to be more reliable and accurate for the identification of malignant breast lesions. However, when these two tests were utilised in tandem, a better outcome and diagnosis could be achieved. Keywords: Ultrasonography, FNAC, Core needle biopsy, Breast malignancy

Traditional Korean Medicine Treatment for Sequelae After Tamoxifen in Breast Cancer Patients: Two Case Reports

Abstract: Objective: The purpose of this study is to report two cases of breast cancer patients whose side effects after Tamoxifen were treated with traditional Korean medicine.Methods: Two breast cancer patients underwent Tamoxifen after breast-conserving surgery, and both were treated with traditional Korean medicine. Subjective discomfort symptoms were evaluated using the Numerical Rating Scale. Adverse events were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 5.0.Results: After treatment with traditional Korean medicine, the discomfort symptoms that occurred after Tamoxifen, such as osteoarthritis, hot flushes, and cold sweat, all gradually improved. In addition, no hematologic, hepatic, or renal side effects were observed from the traditional Korean medicine treatment.Conclusion: This case study suggests that traditional Korean medicine may contribute to the improvement of side effects caused by Tamoxifen and enhance the quality of life of patients.

Profile of Fibroadenoma Mammae Patients at MRCCC Siloam Semanggi Hospital 2019-2020

Abstract: Fibroadenoma mammae is a benign tumor in the breast that can grow in women aged 14-35 years. FAM has a solid mass with a rubbery consistency, is well-defined, and has low cellularity cells. FAM is classified as a benign tumor but can increase the risk of breast cancer by as much as 2.17 times. There are at least 10% of women in the world have FAM lumps. Jakarta Breast Center reported 1,971 out of 2,495 patients suffering from benign FAM tumors. FAM incidents are increasing yearly, and the concerns are often misinterpreted as malignancy. Until now, the cause of FAM cannot be known with certainty. Several risk factors have been identified, such as family genetics, age, hormones, radiation exposure, and contraceptive use. This study aims to determine the profile of FAM sufferers at the MRCCC Siloam Semanggi Hospital in 2019-2020. The research was conducted by total sampling method using anatomic pathology archives. Research on 131 patient records found that the largest age group occurred at 16-30 years, with as many as 68 patients (51.9%). Based on the location of the breast, most FAM lumps were found on the right side in 58 patients (44.3%), with the majority having one lump in 92 patients (70.2%). The most commonly found FAM was > 6cm in 52 patients (39.7%), with the most commonly found consistency being supple in 102 patients (77.9%), and all of them had clear boundaries in 131 patients (100%). Women with risks and suspicions of breast lumps are expected to do early detection with the BSE procedure.

Cytology of breast lesions: a retrospective study in a northern indian state of himalayas.

Abstract: Background: Palpable breast lump, breast pain, and nipple discharge are common symptoms of breast disease. Breast cytology (fine-needle aspiration, nipple discharge smear, and touch preparation) accurately identifies benign, atypical, and malignant pathological changes in breast specimens. This study aims to determine the types of breast lesions diagnosed by breast cytology and assess the clinical adequacy of narrative reporting of breast cytology results. Methods: Medical records of 390 patients presenting to breast or general surgery clinics in Dr. Rajendra Prasad Medical College, Tanda between four years were evaluated retrospectively. Results: Of the 390 diagnosed breast lesions, 89.7 % (n = 350) occurred in females, while 10.3 % (n = 40) occurred in males, giving rise to a female-to-male ratio of 8.8:1. Neoplastic breast lesions (n = 296) comprised 75.9 %, while non-neoplastic breast lesions (n = 94) comprised 24.1 % of all diagnosed breast lesions. The neoplastic lesions were classified as 72.3 % (n = 214) benign and 27.7 % (n = 82) malignant, resulting in a benign-to-malignant ratio of 2.6:1. Fibroadenoma (n = 136) and gynecomastia (n = 33) were the most frequently diagnosed breast lesions for women and men, respectively. Conclusions: Breast cytology effectively diagnosed neoplastic and non-neoplastic breast lesions. Neoplastic breast lesions occurred more frequently in women whereas non-neoplastic lesions occurred more frequently in men. To address the limitations associated with narrative reporting of breast cytology results, a synoptic reporting format incorporating the United Kingdom’s National Health Service Breast Screening Programme’s diagnostic categories (C1 to C5) is recommended for adoption by this hospital.