An Etiological and Clinicopathological Study of Breast Lump in Rajasthan, India, with Special Reference to Carcinoma Breast

Abstract

Objectives: Carcinoma of the breast is the most common cause of cancer death in women worldwide; in Indian women, it is second only to cervical cancer. The aim of this study was to study the etiological and clinicopathological features of patients presenting with a breast lump in the desert city of Jodhpur, India, with special reference to breast cancer. Material and Methods: This was a retrospective study that involved 648 patients over a 5-year period from 2011 to 2015 in Jodhpur city, Rajasthan. Results: The most common type of lump encountered was fibroadenoma (53.6%) followed by malignancy (51.7%). Of breast cancers, 99.1% were in females with a preponderance in premenopausal women (56.1%). The most affected age group was the fifth decade. Only 11.9% of cases presented within 1 month and 3.75% had a history exceeding 4 years. Lump size was more than 15 cm in 3.07% and <1 cm in 2.7%, with most situated in the upper outer quadrant (54.2%). Most of the patients were in tumor-node-metastasis Stage II (45.4%); the reported mortality rate was 4.1% and recurrence rate was 2.97%. Infiltrating duct carcinoma constituted the majority (86.7%) of cases. Modified radical mastectomy was the most performed procedure (37.2%) and the most favored chemotherapy regimen was CMF. Gynecomastia constituted 2.6% of all breast lumps, while tuberculosis made up 0.46%. Conclusion: Our results show that the patterns of breast disease are in keeping with the demography of the region. However, clinical presentation appears to be strongly influenced by sociocultural factors such as ignorance, taboos and parity, as well as rural habitation and access to health care. We emphasize the need for proper documentation, especially a cancer registry.