Evaluation of cases of benign breast diseases

Kavimozhy Ilakkiya, P (2013) Evaluation of cases of benign breast diseases. Masters thesis, Tirunelveli Medical College, Tirunelveli.

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Abstract

INTRODUCTION: Breast is an important feature of female anatomy particularly representing feminity. Contemporary concepts of female beauty and feminity necessitates the breast to be esthetically acceptable in all the situations. It not only symbolises feminity, mammary glands are also important for the survival of the newborn and thus of the species and portrays the womanhood. Any change within the breast that comes into notice in a female has a significant impact on her well being. So, its more of a psychological and emotional concern. Rather than disease per se , its the fear of malignancy makes her more apprehensive and anxious. Though breast cancer being centered in any case with a breast lump, every physician has to remember that benign lesions are more common than malignancy. Enough attention has not been given for the benign breast disorders as much as it was deserved. We have only few papers, studies discussed about this subject. Benign tumours of the breast is 4 to 5 times more common than malignancy. Benign breast diseases are common disorder, in up to 30% of women will suffer from benign breast diseases requiring treatment at some time or the other in their lifetime.1 Over 80% of the breast problems present as pain and or lumps in the breast. RATIONALE BEHIND THE STUDY: Benign breast disease which cause a great deal of discomfort (both physical and mental) to the patient, who have doubt that it could be malignant, which has to be ruled out. The need for study is to analyse the spectrum of benign breast disease with respect to age, sex, mode of presentation, clinical features and management. AIMS & OBJECTIVES: 1. To study the patients presenting with various types of benign breast diseases. 2. To study the association of benign breast disease with menstrual status, marital status, parity, family history & personal history. 3. To study the common presentation of benign breast diseases. 4. To correlate the results of FNAC with that of histopathology in all the post operative cases. 5. To study the treatment modalities in benign breast diseases. MATERIALS AND METHODS: It is a prospective study aimed at evaluation of cases of benign breast diseases in Tirunelveli medical college & hospital from the period of feb 2011 - july 2012 over a period of 18 month. Source of Data: Tirunelveli Medical College, Hospital, Tirunelveli. Design of Study: Prospective study. Period of Study: 18 Months. Sample Size: 109 cases of benign breast diseases proven histopathologically. Method of Collection of Data: Study group comprises of 109 female patients with benign breast disease admitted in Tirunelveli medical college and hospital during the period of 18 months. Patients clinically diagnosed as having BBD are admitted for further evaluation. After obtaining an informed written consent from the patient, detailed history and clinical examination will be done as per my proforma designed. The proforma designed in the questionarre form. With the aid of routine investigations and investigations specific to the disease per se are also supplemented to confirm the diagnosis. The management will be decided according to the provisional diagnosis made after the investigations. The histopathological report followed up. Finally, histopathologically proven cases of BBD will be included in the study with consideration to inclusion and exclusion criteria. If needed secondary analysis of medical records of these patient will be used to fulfil the missed and remaining data. Pathology report of all these patient collected from my collobarating department. The proformas are completed and finally compiled data are to be profiled. INCLUSION CRITERIA: 1. Females > 12 years. 2. Patients admitted with a provisional diagnosis of benign breast disease. 3. Patients who are found to have benign breast tumors on clinico-pathological examination. EXCLUSION CRITERIA: 1. Females < 12 years, 2. Patients diagnosed to have malignancy during evaluation, 3. Pregnant females, 4. Males. CONCLUSION: Fibroadenoma is the commonest BBD followed by phyllodes, Fibrocystic diseases of the breast. Most common BBD in Indian subcontinent includes fibroadenoma followed by fibrocystic disease. Benign breast disease commonly occurs during the 2nd and 3rd decade and fibroadenoma being the common BBD in the same age group. FCD commonly seen among 3rd decade and phyllodes commonly observed among 4th decade. It has been noted that no age is immune to BBD. Most BBD observed after second child birth. During lactation, breast abscess cases noted. Role of family history and OCP s in causation of BBD is not significant in the study group. Most common presentation of BBD was lump in association pain. Most of them presented with short duration of complaint. So the early presentation could partially be due to the greater awareness of the disease of the breast and fear that breast lump could be malignant. Unilateral involvement of breast lesion was common, mostly involved the upper outer quadrant and usually a solitary lesion. Average size of the lesion was about 2 – 5 cm. Most of them were firm with classical mobility demonstrable in fibroadenoma cases, only in 1/3rd of the cases. All patients in study group were managed surgically. Though the present trend of conservative management has reduced number of surgical procedures. However in view of the anxiety regarding symptoms, distance to be travelled, poor socioeconomic conditions leading to difficulty in follow up, so patients opt for an early surgical method of resolution of symptoms and fear of malignancy. Final diagnosis was relayed upon pathological examination of the specimen and further follow up of the patient planned accordingly. The sensitivity and specificity of clinical examination was 93.5% and 40.54% and that of FNAC was 94.2% and 42.5% in cases of FA. One interesting case of benign phyllodes recorded in a 13 year female who has not attained menarche.

Item Type: Thesis (Masters)
Uncontrolled Keywords: benign breast diseases, Evaluation, cases.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 09 Jun 2018 17:35
Last Modified: 13 Jan 2020 15:13
URI: http://repository-tnmgrmu.ac.in/id/eprint/8360

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