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A study of histopathological assessment of mastectomy specimens at tertiary care centre in western India.

Sunita Mistry, Minesh Gandhi, Piyush R Patel, Cherry K Shah, Nailesh R Shah.

Background: Carcinoma of the breast is the most common malignancy in adult women and the second leading cause of cancer death in women. There is an uncertainty over natural history and factors leading to emergence of cancer of breast in women as well as in men.

Aims & Objective: To study the various morphological types of malignant lesions and their age distribution, from Mastectomy and Post lumpectomy Mastectomy received from in and around Ahmadabad district, at Department of Pathology, Smt NHL MMC and Sheth VS Hospital, Ahmedabad.

Material and Methods: Out of the specimens of breast which presented as mastectomy and post lumpectomy mastectomy specimens of breast to the Department of Pathology, Smt NHL MMC and Sheth VS Hospital, Ahmedabad for histopathological examination, 100 cases were taken up for this study. Detailed clinical data were noted as per the proforma with emphasis on history, gross examination and microscopic examination.

Results: Majority of cases were carcinoma (87%). Majority of women (63%) were of age 41-60. Painless lump (77%) was found as most common symptoms, while nipple retraction was found in 3% cases and Peaude orange skin was found in 1% cases. Majority of patients had lump in the left breast (53%) followed by right breast (47%). 40% of patients presented with lump in the upper outer quadrant and 11% in lower outer quadrant. Out of the total 88 carcinomas of breast encountered, 85.2%, were Infiltrating Duct Carcinoma [IDC (NOS)], 1.1% were Ductal Carcinoma in Situ (DCIS), 1.1% each of mucinous carcinoma, invasive papillary carcinoma and acinic cell carcinoma, 2.2% were metaplastic carcinoma and 6.8% were invasive lobular carcinoma. Most of tumour was T3 (53.48%) followed by T2 (29.06%). In the case of pathological staging The majority of patients were present in stage IIIA (25.58%), stage IIB (24.41%) and stage IIIC (22.09%), followed by Stage IIA (18.60%). Vascular invasion was 21.3% in the case of IDC, 66.6% in the case of ILC and 25% in the case of stromal carcinoma.

Conclusion: This study highlights the importance of histopathological examination in breast lumps not only in establishing the final diagnosis, but also in predicting the prognosis by typing, staging and grading malignant neoplasm of breast.

Key words: Carcinoma of Breast, Histological examination, vascular invasion

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