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Pattern of palpable breast lesions on fine needle aspiration cytology: a retrospective and prospective analysis of 1,000 cases

Shikha Ghanghoria, Swati Soni, Harshul Patidar, Khushboo Likhar.


Background: In both developed and developing countries, breast lumps comprise a considerable amount of surgical cases in women.

Objective: To look the frequency distribution of various breast lesions on fine needle aspiration (FNA).

Materials and Methods: The 1,000 patients who presented with palpable breast lump, age group including 16–60 years and both sexes, were included in the study. Frequency distribution of various breast lesions with respect to age and sex was studied.

Result: The majority [98% (N = 980)] of patients were female subjects and rest [2% (N = 20)] male subjects. With reference to the age, maximum [66.6% (N = 666)] patients were between second and third decades and rest [33.4% (N = 334)] in fourth and fifth decades. Benign breast lesions contributed to majority of the cases [57.3% (N = 573)], malignant breast lesions to 26.8% (N = 268) of the cases, and the inflammatory lesions to 15.9% (N = 159) of the cases. Of the 268 (26.8%) malignant breast lesions, 38% (N = 102) of cases were aged between 41 and 50 years, 33% (N = 88) of cases 51–60 years, and 29% (N = 78) of cases 31–40 years. In malignant breast lumps, majority are duct carcinoma NOS (N = 229), while in benign breast disease, fibroadenoma are found to be the commonest one. Cytology grading of malignant lesion showed maximum cases with grade II, followed by grades I and III.

Conclusion: With experienced hands, fine needle aspiration (FNA) cytology is a safe, cost-effective, and reliable technique for preoperative evaluation of palpable breast lumps. FNA features are more informative when combined with clinical and radiological findings. Fibroadenoma forms the major bulk of benign breast lesions, followed by duct carcinoma. Epithelioid cells when seen in inflammatory breast FNA smears, tuberculosis must be ruled out. In India, breast carcinoma is noted in younger patients when compared with western countries. Grading of breast carcinomas must be done on FNA smears for selecting the neoadjuvant therapy. Clinical breast examination and mammography screening in female subjects should be encouraged in developing countries from the third decade onward for early detection of breast carcinoma.

Key words: Breast lesion, cytology, grading, fibroadenoma

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