Cyto- histopathological correlation of breast lesions –A rural hospital based study

Introduction: Breast carcinoma is the most frequent cancer among women worldwide. Breast lesions most commonly present as lump. Fine needle aspiration cytology (FNAC) is an ideal initial diagnostic modality considering patient’s comfort, lack of requirement of anesthesia, rapid analysis and reporting, and few false positive results. Materials and Methods: In the present study cyto-histological correlation was done in 61 patients. Observation and Result: Out of 61 patients, 43 were benign, 17 were malignant and one was inflammatory on cytological examination. On histopathological examination 41 were benign and 19 were malignant and one was found to be inflammatory. Cyto-histopathological correlation was found in 96.7% cases. Conclusion: FNAC is a useful preliminary tool for diagnosing the breast lumps in our set up. Keyword: Benign, Breast, Fine needle aspiration cytology, Histopathology, Malignant. Introduction Breast carcinoma is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed in 2012 (second most common cancer overall). This represents about 12% of all new cancer cases and 25% of all cancers in women. The rate of incidence varies from 19.3 per lac women in Eastern Africa to 89.7 per lac in Western Europe. However, the mortality rate is less and is 6-19 per lac because of availability of facilities for early diagnosis and treatment of breast cancer in developed countries. But over last ten years, breast cancer has been rising steadily, and for the first time now, breast cancer is the most common cancer in women in India, way ahead of cervical cancer. Both, the incidence, as well as deaths, due to breast cancer are more than cervical cancer. It is estimated that during the year 2012, about 144,937 new cases of breast cancer were diagnosed and 70,218 women were died of cancer in India. Breast lesions most commonly present as lump. Fine needle aspiration cytology (FNAC) is an important initial diagnostic modality in breast lumps as there is no need for anesthesia and rapid analysis and reporting can be done with few false positive results. FNAC is one of the important components of ‘triple approach’, which has been widely accepted for the preoperative diagnosis of breast lesions which includes clinical and radiological examination in conjunction with FNAC features, to diagnose the breast lesions and to determine the best management plan for the patient. However, a definitive diagnosis sometimes cannot be made by FNAC alone, either due to inherent limitations of any cytological examination or the inability to obtain adequate material for diagnosis. This study is undertaken to study the burden of breast diseasesin a rural area. The information gathered about the prevalence and spectrum of breast lesions helps in the development of strategies for proper health care planning. It can also be helpful in determining usefulness of FNAC in our setup. Aims & Objectives 1. To study the morphological spectrum of various breast lesions in patients with an apparent breast lump. 2. To correlate the cytological findings with histopathological examination. 3. To determine the accuracy of aspiration cytology in the diagnosis of the breast lesions. Materials & Methods This hospital-based cross sectional descriptive study was carried out in Department of Pathology, C.C. M. Medical College, Durg (Chhattisgarh) for a total duration of 12 months from January 2015 to December 2015. The present study included 61females presenting with palpable breast lump in the outpatient department. FNAC was carried out using 10 ml plastic disposable syringe and disposable needles of 23-24gauge. The smears were stained with Field’s stain and Giemsa stain. Smears with adequate material were followed for subsequent histopathological correlation on tru-cut biopsies, lumpectomies and mastectomies. The patients with inconclusive cytology and who underwent FNAC but did not undergo subsequent histopathological investigation were excluded from the study. Observations & Results The age range for total 61 patients was 15-75 years. Majority of patients (57%) patients were in age group between 15-30 years (Table 1). Out of 61, 10 (16%) patients were unmarried. Varsha Pandey et al. Cytohistopathological correlation of breast lesions –A rural hospital based study Indian Journal of Pathology and Oncology, January-March 2017;4(1):117-121 118 Table 1: Age wise distribution of patients enrolled in