Study of Breast Lumps in Females up to 40 Years of Age at Government Medical College, Nagpur

Abstract

BACKGROUND Breast diseases have been known to mankind since ancient times. However, earlier it was a matter of taboo and embarrassment that meant detection and diagnosis were rare. But the involvement of more women and actively bringing out the disease into open is a recent phenomenon. Various types of lesions from inflammation to carcinoma can affect the breast. Lump in breast is the commonest complaint which the patient presents to the surgeon. Different aetiologies of breast lump need different lines of management. We wanted to study the clinical profile of patients up to 40 years presenting with a discrete breast lump, diagnose different pathological conditions causing them and also study different investigations used for diagnosis. METHODS The study was done from October 2013 to December 2015 on a total of 305 consenting patients attending surgery outpatient department and those patients admitted in wards at government medical college, Nagpur were up to 40 years of age with a complaint of a breast lump. Clinical profiles of patients up to 40 years of age presenting with breast lumps were studied along with different investigations for diagnosis and different treatment modalities. RESULTS The highest incidence noted was fibroadenoma (178) in 58.36 % of cases and the lowest incidence was of duct ectasia (3) in 0.98 % of cases. The incidence of fibroadenoma in married women was 46.06 % and in unmarried was 53.93 %. The lowest number of breast lump cases was found in the 10-20 yrs (59) age group and a maximum number of breast lump cases was found in the 21-30 yrs age group (140). Total 74 patients diagnosed with malignancy were the most commonly affected patients in the age group of 31 – 40 yrs. Out of 305 patients with a history of self detected lump 87 i.e. 28.52 % had mastalgia and 16 patients presented with nipple discharge. Ultrasound showed only their benign breast disease characteristic and the definitive diagnosis was not possible in them. CONCLUSIONS Rate of benign pathologies is comparatively much higher than malignant ones in young females; however, increasing trends of malignancy in this age group cannot be neglected. With the global trend towards an increase in the incidence of breast malignancy, for every patient with a breast lump, cytological / tissue diagnosis by an expert pathologist must be established, before a further line of treatment can be planned. KEY WORDS Fibroadenoma, Malignancy (CA Breast), OPD (Outpatient Department), Trucut Biopsy.