Spectrum of Benign Breast Lesions : A Cytologic Study

Abstract

INTRODUCTION:Open biopsy is widely considered to be the procedure of choice for diagnostic tissue sampling of bone tumors. However, associated disadvantages include in-patient procedure requiring hospitalization, risk of infection, hematoma formation and pathological fractures. As an alternative FNA cytology is increasingly used as a diagnostic modality. It is a challenging technique due to difficulties in approaching bone lesions and obtaining adequate material. AIMS: 1. To study the prevalence and distribution of various breast lesions in women of various age groups. 2. To classify the smears into C1-C5 category. 3. To enumerate the difficulties encountered in this study. 4. To emphasize the role of FNAC in diagnostic workup in breast lesions. MATERIALS AND METHODS: FNAC was done on 208 cases of breast lesions from September 2011 to July 2012 in department of Pathology, Bowring hospital, BMC&RI, Bangalore. Cases presenting to the OPD with breast lumps were subjected for FNAC. Aspirations were carried out with 10ml disposable syringe with a 22guage needle, material was obtained. Aspirates were smeared and few of them were immediately fixed with methanol and stained with H&E, rest of the smears were air dried for MGG staining. The diagnostic criteria C1-C5 as recommended by NHS breast screening program has been incorporated for reporting the slides along with pathological diagnosis wherever possible. RESULTS: 1. In countries with limited resources like India, FNAC may be used as the first line of diagnostic tool for evaluating breast lesions. 2. Breast FNA continues its monopoly over core biopsy and open excision biopsy. Benign conditions of breast can be diagnosed easily on FNA if done accurately. The current usage of C1-C5 categories in typing the breast lesions gives a wide scope for pathologist to place the doubtful lesions freely in the categories. However a disease specific diagnosis was preferred by the clinicians. 3. In females the commonest benign lesion encountered was fibroadenoma (43.5%) followed by benign breast disease (20.12%) &fibro cystic disease (11.03%). 4. In males the commonest cause of breast enlargement was benign breast disease(gynaecomastia) (91%) followed by fibroadenoma in( 9%).