Clinico-pathological study of benign breast disease

Abstract

Objective: To study the clinical patterns of Benign Breast Disease (BBD) in females and to correlate them with pathological findings. Methods: One hundred females who attended Regional Institute of Medical Scieces (RIMS), Imphal with various forms of BBD during the period from May 2005 to June 2007 were studied. Clinical diagnosis was compared with cytological or histological findings wherever possible and accuracy of clinical diagnosis was evaluated. Results: Main presentations of BBD were a lump in the breast, breast pain and nipple discharge. The mean age at presentation was 28.26 years. Breast lumps accounted for 88 (88%) cases of which 18 (20.45%) had associated complaints like breast-pain and nipple-discharge. Of the 26 (26%) cases of breast-pain, 18 (69.23%) had an associated breast lump or nipple discharge. Nipple discharge was present in 8 (8%) case with or without a lump or pain in the breast. Fibroadenoma was the commonest lump accounting for more than half of the lumps. Fibroadenosis and galactocele came next with 22.73% and 11.36% of the breast-lumps respectively. Clinical diagnosis of breast lump, as confirmed by cytology or histology, was accurate in 76.14% of the lumps as a whole while the accuracy was about 90% in case of fibroadenoma and fibroadenosis alone. Conclusion: A lump in the breast is the commonest presentation of BBD. Breast pain and nipple discharge are other symptoms. More than one symptom may be present in the same patient. Commonest age-group is 21-30 years. Among breast-lumps, fibroadenoma is the commonest followed by fibroadenosis and galactocele. Clinical diagnosis of benign breast lump is accurate in 70 to 90 percent cases. Certain lumps like fat necrosis, parasitic infestation are often difficult to diagnose clinically and can be confirmed only histo-cytologically.