Abstract

BENIGN BREAST DISEASES: A SURGICAL CONUNDRUM

Dr. Chethan Narayan* and Dr. Navaneeth Srinidhi R.

ABSTRACT

Introduction: The presence of a lump in the breast is a great cause of anxiety, apprehension, and uncertainty to most patients. This may be accrued to the increasing public awareness of breast cancer which is presently the most common female malignancy worldwide. Nevertheless the vast majority of breast lesions are benign. Benign breast diseases however constitute a heterogeneous group of disorders including developmental abnormalities, epithelial and stromal proliferations, inflammatory lesions, and neoplasms. Since the literature on benign breast diseases in India is scanty, the aim of present study of present study is to see the pattern of benign breast lumps in females presented to our tertiary care hospital and to study its correlation with pathology findings. The study is observational and prospective. Aims and Objectives: 1) To study the different types of benign breast diseases in females, their clinical presentation and pathological findings. 2) To assess the diagnostic accuracy of clinical examination compared to FNAC and post operative histopathological examination. 3) To study about management aspects of benign breast diseases in females. Materials and Methods: The cases presented in this study are those patients admitted as in patient basis to the District Hospital, Kolar who have benign breast diseases in the time period between Jan 2018 to June 2020. This is a prospective study in which 50 patients of benign breast diseases diagnosed based on their clinical history and thorough clinical examination were randomly selected and further management planned based on their willingness for undergoing all necessary investigations and surgery. All patients were studied and clinical findings were recorded, necessary investigations ordered and appropriate treatment given. All cases were followed up to discharge and subsequently for a follow up period of at least 6 months. All the data were analyzed and the results were tabulated. Results: 62% of the cases were from rural population and all the infective breast lesions were from the rural area. Commonest tumour found among benign breast disease was fibroadenoma occurring in 70% of case. Common presentation in most of the benign breast lesions was painless lump in the breast except fibroadenosis, breast abscess and acute mastitis. Majority of cases were in reproductive age group. Fibroadenoma was encountered commonly in the age group of 21-30 years, where as fibroadenosis was found in the perimenopausal period. 58% of the benign breast lesions found in the left breast. 5.7% of fibroadenoma were bilateral. FNAC is a safe, cost effective and easy method to confirm the diagnosis of most benign breast diseases with good sensitivity (88%). Most of the benign breast diseases can be diagnosed clinically with fair accuracy. Conclusion: Commonest benign breast tumour found was Fibroadenoma(70%). Majority of the patients were in the reproductive age group. Fibroadenoma was more common in 2nd decade of life, whereas fibroadenosis found in the perimenopausal period. Majority of benign breast lesions presented with painless lump except fibroadenosis, breast abscess and acute mastitis. All the cases of inflammatory breast lesions were found among rural population. The high incidence of infective diseases may be due to poor hygiene and infected environment in this low socio economic and backward group. FNAC was a diagnostically accurate procedure with respect to benign breast diseases, especially for fibroadenoma and phyllodes tumour.

Keywords: Benign breast disease, ANDI, Fibroadenoma, Phyllodes tumour, Fibroadenosis, FNAC, Histopathology, Excision.