Benign Breast Diseases: Hundred Cases

INTRODUCTION: Benign diseases of breast are the commonest diseases affecting the female covering much morbidity and anxiety in them. Upto 30% of women will suffer from benign breast lesions requiring treatment at some time of their life. Premenopausal women are most affected. The most common symptoms are pain (47%) and lump (35%) Aim of the treatment is to exclude malignancy and once this has been done, to treat any remaining symptoms. Out study is intended to find out the common Benign breast diseases affecting the women in reproductive age group and the common clinical presentation and various investigations adopted and analyse different modalities of treatment. AIM OF THE STUDY: To discuss about the benign lesions of breast based on history, clinical features, physical examination, cytological study, histopathological examination and management. The purpose of the study is to assess: a) The age groups commonly affected. b) The clinical presentation of various benign diseases. c) The cytological features. d) The usefulness of F.N.A.C. in non neoplastic disease. e) The efficacy of medical and surgical management of various benign lesions. MATERIALS AND METHODS: During the 2 years period between October 2004 to October 2006 at Kilpauk Medical college Hospital, 100 cases of Benign breast disease were studied in our surgical inpatient department. We had 75 cases of Fibroadenoma,10 cases of Fibrocystic diseases, 6 cases of gynecomastia;1 case of breast cyst, 3 cases of chronic abscess,1 case of filarial mastitis were examined and studied. We analyzed the clinical features, age incidence, the quadrant affected, axillary nodal status, nipple discharge, FNAC & HPE report. Detailed history, clinical examination & relevant investigation including FNAC & excision biopsy of suspected lumps were undertaken from patients who presented to our surgery department. OBSERVATION: All patients belong to 15-40 yrs age group except 4 cases 53 yrs, 55 yrs, & 2cases of 73 yrs. Age incidence, clinical presentation & management were analyzed. FNAC & excision biopsy done in all cases. All the above features were taken into consideration and analyzed in the study. RESULTS: Lt breast was involved in (40) cases of fibroadenoma & Rt breast was involved in 6 cases of fibrocystic disease. Rt breast involved in 34 cases of fibroadenoma & Lt breast in 4 cases of fibrocystic disease. Both breast involved in 1 case of fibroadenoma Whole breast was involved in giant fibroadenoma & phylloides tumour. Rt upper lateral quadrant [22] commonly involved in fibroadenoma followed by Lt upper medial quadrant [20]. Then by Lt upper lateral [17] & Rt upper medial quadrant. Rt upper medial quadrant [5] followed by Lt upper medial quadrants in fibrocystic disease. CONCLUSION: The study proved that Benign lesion are the commonest lesion of female breast, especially of the reproductive age group. Fibroadenoma is the commonest followed by Fibrocystic disease. Rt upper lateral quadrant is the commonest area affected in Fibroadenoma. Rt upper medial quadrant commonly involved in Fibrocystic disease. Lump & pain are the commonest symptoms. FNAC is the single most useful investigation with high diagnostic accuracy in experienced hands. The accuracy in Fibroadenoma is 95% & in the Fibrocystic disease is 63%. Excision biopsy is the investigation of choice in doubtful case. Histological confirmatory report should be obtained if there is disagreement between cytological & clinical assessment. Some lesion with feature of malignancy like skin ulceration, nipple retraction & discharge may still be benign. Complete surgical excision in majority & simple mastectomy in massive involvement & in recurrence.