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Primary breast tuberculosis is a rare disease under extrapulmonary tuberculosis category. It tends to affect females of reproductive age rather than postmenopausal women or prepubescent girls. This rare form of disease poses a challenge in diagnosing as imaging can mimic the appearance of both benign and malignant breast lesions. We describe a case of primary breast tuberculosis in a young female who presented with a persistent left breast lump. and was diagnosed with chronic left breast abscess. Histopathological examination of the lesion was consistent with granulomatous mastitis, secondary to mycobacterium tuberculosis infection. The patient was treated with a 6-month course of anti-tuberculosis drug with complete resolution of the symptoms and the left breast lesion on serial ultrasound imaging.

Introduction: A palpable breast lump is a common diagnostic problem for clinicians and surgeons. Fine-needle aspiration cytology (FNAC) has many advantages such as less cost, less sample processing time, less pain, less chance of hematoma, and less discomfort. FNAC with cell block preparation further increased both sensitivity and specificity by nearly 100%. With the cell block preparation, we can also use newer tests like estrogen receptor–progesterone receptor–human epidermal growth factor receptor 2. Aims: The aim of this study was to derive conclusions about the correlation, including sensitivity, specificity, positive and negative predictive values (NPVs), and the diagnostic accuracy of FNAC, with or without cell blocks, compared to the final histopathology in cases of palpable breast masses. Materials and Methods: A cross-sectional prospective study was conducted after getting approval from the Human Ethics Research Committee from January 2018 to December 2019, which included 65 patients. Patients diagnosed clinically for breast lumps who underwent diagnostic FNAC with cell block, followed by a histopathological examination at our hospital, were included in the study. Results: FNAC without cell block sensitivity, specificity, positive predictive value (PPV), NPV, efficiency rate, and diagnostic accuracy are 91.3%, 100%, 100%, 90.1%, 86.2%, and 96.5%, respectively. FNAC with cell block sensitivity, specificity, PPV, NPV, efficiency rate, and diagnostic accuracy are all 100%. All of our results beat the standard estimate. Conclusions: Fine-needle aspiration cytology is a patient-friendly, easy, reliable, repeatable, and simple diagnostic test. Whenever it is combined with cell block preparation, improves the accuracy of FNAC diagnosis which is more accurate and comparable to golden-standard biopsy with histopathology examination.

Background: In India, breast carcinoma is the 2nd most common malignancy in women. Incidence increases every year which ranges approximately 20-32%. Incidence of breast cancer shows "AGE SHIFT" over the past twenty years in India that is incidence increased from 6 to 17% in the age group of 30-40 years. The 'Modified Triple Test' utilizes-Physical Examination, Ultrasonography of the breast as the radiological method, and FNAC for the diagnosis of palpable breast lumps. It is gaining acceptance with the recent advances in technology and refinements in the interpretative criteria of sonographically characterized masses. Methods A prospective cross sectional study of 50 female patients attending the out patient department of General Surgery, K.R. Hospital, Mysore, between March 2022 to January 2024, with the complaint of a palpable lump/lumps in the breast was undertaken. Results Most commonly affected age group being 30-39 years. Incidence increased from 7 to 16% between the age group of 30 and 40 years. The calculated P - value for parity study is 0.017 and it is shown that malignancy is common among nulliparous. For the menstrual status, the calculated p-value is 0.044 is significant. The breast tumor is common at left side account for about overall 54% age. Fibroadenoma is the most common benign tumor. It was inferred from the study that clinical examination has a sensitivity of 87.5% which means that around 12.5% of the breast carcinoma cases are missed clinically. Results of Modified Triple Test were Sensitivity: 100%, Specificity: 97.37%, PPV: 91.67%, NPV: 100%. Hence the modified triple test can be used as a reliable and fairly accurate means of diagnosis of breast carcinoma. Conclusion Our results show that the diagnostic accuracy of physical examination breast USG and FNA/CNB combined is comparable to that of histological examination. Ultrasound replacing mammography serve as an effective imaging modality in palpable breast lumps and is also more comprehensive. CNB is a suitable alternative when FNA is inconclusive, also offers additional information. Thus the use of MTT to complement findings in differential diagnosis of a lesion in a symptomatic women seeking medical care deserves acceptance and further evalution. [ABSTRACT FROM AUTHOR]

Palpable breast masses are common reasons for presenting to the primary care or emergency clinic setting. Although most palpable masses are benign in etiology, the possibility of malignancy exists and may be anxiety-inducing to patients. A systematic approach to history-taking, to clinical breast examination and to imaging is important for the adequate evaluation of a palpable breast mass. This article aims to provide medical students with a stepwise approach to the evaluation and diagnosis of palpable breast masses. Given the wide spectrum of diseases associated with palpable masses, the differential diagnosis and management is out of the scope of this paper. However, we will touch upon the breast cancers most commonly associated with breast masses and briefly mention their respective treatments.

Background: Breast pain is the second most common breast symptom (after breast lump) for which women seeks medical attention. Breast pain can affect daily life, including sleeping, or physical, social, and work-school life. Mastalgia is one of the common causes for women in tier 2 city visiting health care facility but there are only few studies which focus on demographic findings and ultrasonographic findings in mastalgia. Aims and Objectives: The objective of this study was to study demographics of breast pain in a tier 2 city and ultrasound evaluation of mastalgia. Materials and Methods: In this prospective study, 143 patients presenting with mastalgia irrespective of focality, duration, or cyclical nature were included. In these patients, we studied demographic profile and ultrasonographic findings in mastalgia. Results: About 37% women were in 20–29 years of age group and least number was in 70–79 years of age group. About 86% of women in our study were in reproductive age group. Most patient with mastalgia have associated palpable lump (58%) followed by 43% patients with mastalgia and nipple discharge, only 27% of patients have mastalgia alone whereas 4% women have pain with skin changes. The majority (49%) of mastalgia cases fall under the breast imaging-reporting data system (BI-RADS)-I category while cases in BI-RADS-IV and V category were 2 and 1, respectively. Conclusion: Women in their reproductive age group and in their 3rd decade of life are more prone for mastalgia. Ultrasonography is also helpful in detecting cancers in setups where routine mammography is not possible.

The triple test is an initial approach used for the evaluation of breast lumps. The clinical and physical examination are a critical component. Various studies indicate that there is difference in the clinical examination findings of benign vs. malignant breast lumps. The aim of the present study was to evaluate the significance of differences in the clinical examination of benign and malignant breast lumps from a cytological perspective. For this purpose, 301 consecutive breast lumps examined using fine needle aspiration cytology (FNAC) cases were included in the study. The patients were divided into category C-1 to C-5 based on the International Academy of Cytology classification system for the FNAC reporting of breast lesions. The clinical examination parameters studied included the age of the patients, duration, consistency, tenderness, mobility, location in the breast and the laterality of the lump. The cases were grouped into the benign group (C1, C2 and C3) and suspicious/malignant group (C4 and C5). The median duration of the benign lumps was 4 months compared with that of the malignant lumps, which was also 4 months. The malignant lesions were more likely to be in the upper quadrant, and were also non-mobile and hard (non-tender) upon a clinical examination. There were statistically significant differences in some of the clinical features, namely in the duration of presentation, site, mobility and consistency of the breast lump among various cytological category. On the whole, the present study re-emphasizes the importance of a thorough clinical examination for the better management of patients with breast lumps. [ABSTRACT FROM AUTHOR]

Background: Breast pain is the second most common breast symptom (after breast lump) for which women seeks medical attention. Breast pain can affect daily life, including sleeping, or physical, social, and work-school life. Mastalgia is one of the common causes for women in tier 2 city visiting health care facility but there are only few studies which focus on demographic findings and ultrasonographic findings in mastalgia. Aims and Objectives: The objective of this study was to study demographics of breast pain in a tier 2 city and ultrasound evaluation of mastalgia. Materials and Methods: In this prospective study, 143 patients presenting with mastalgia irrespective of focality, duration, or cyclical nature were included. In these patients, we studied demographic profile and ultrasonographic findings in mastalgia. Results: About 37% women were in 20–29 years of age group and least number was in 70–79 years of age group. About 86% of women in our study were in reproductive age group. Most patient with mastalgia have associated palpable lump (58%) followed by 43% patients with mastalgia and nipple discharge, only 27% of patients have mastalgia alone whereas 4% women have pain with skin changes. The majority (49%) of mastalgia cases fall under the breast imaging-reporting data system (BIRADS)-I category while cases in BI-RADS-IV and V category were 2 and 1, respectively. Conclusion: Women in their reproductive age group and in their 3rd decade of life are more prone for mastalgia. Ultrasonography is also helpful in detecting cancers in setups where routine mammography is not possible. [ABSTRACT FROM AUTHOR]

NHL Primary of the breast is rare accounting 0.1% of the total malignancy. DLBCL is the most common histology for Primary NHL breast. It presentation is similar to carcinoma breast so biopsy followed by IHC is only method to differentiate between both. Due to rarity of the tumor there is lack of literature on proper diagnosis and treatment. RCHOP is the chemotherapy regime used and radiotherapy role is not clear. Some studies suggest role of CNS irradiation in high risk patient because of high chances of CNS spread in advance stage patient. In this paper we aim to highlight the diagnostic difficulties we faced and the treatment we followed. Here we bring to the knowledge of the reader about the review over diagnosis, clinical feature and treatment of NHL breast along side with two clinical cases to enhance clinical interest of the reviewer.

ABSTRACT: Introduction: A palpable breast lump is a common diagnostic problem for clinicians and surgeons. Fine-needle aspiration cytology (FNAC) has many advantages such as less cost, less sample processing time, less pain, less chance of hematoma, and less discomfort. FNAC with cell block preparation further increased both sensitivity and specificity by nearly 100%. With the cell block preparation, we can also use newer tests like estrogen receptor–progesterone receptor–human epidermal growth factor receptor 2. Aims: The aim of this study was to derive conclusions about the correlation, including sensitivity, specificity, positive and negative predictive values (NPVs), and the diagnostic accuracy of FNAC, with or without cell blocks, compared to the final histopathology in cases of palpable breast masses. Materials and Methods: A cross-sectional prospective study was conducted after getting approval from the Human Ethics Research Committee from January 2018 to December 2019, which included 65 patients. Patients diagnosed clinically for breast lumps who underwent diagnostic FNAC with cell block, followed by a histopathological examination at our hospital, were included in the study. Results: FNAC without cell block sensitivity, specificity, positive predictive value (PPV), NPV, efficiency rate, and diagnostic accuracy are 91.3%, 100%, 100%, 90.1%, 86.2%, and 96.5%, respectively. FNAC with cell block sensitivity, specificity, PPV, NPV, efficiency rate, and diagnostic accuracy are all 100%. All of our results beat the standard estimate. Conclusions: Fine-needle aspiration cytology is a patient-friendly, easy, reliable, repeatable, and simple diagnostic test. Whenever it is combined with cell block preparation, improves the accuracy of FNAC diagnosis which is more accurate and comparable to golden-standard biopsy with histopathology examination. [ABSTRACT FROM AUTHOR]

Abstract Background Primary anorectal melanoma is a rare and aggressive disease accounting for approximately 1–3% of all colorectal and anal cancers. Case report We present a unique case of anorectal melanoma where the primary presentation was the metastatic breast lump which led to the detection of the primary tumor. A 70-year-old elderly postmenopausal female presented with complaint of left breast lump. On fine needle aspiration cytology, May Grunwald-Giemsa and Papanicolaou stained smears examined were highly cellular and showed sheets, clusters and singly scattered highly pleomorphic plasmacytoid cells having high nucleus to cytoplasmic ratio and scant to moderate cytoplasm with enlarged eccentric round to ovoid nuclei. Immunocytochemistry performed on cell block preparation showed tumor cells strongly positive for HMB-45, S-100 and negative for ER, PR, Her2neu, chromogranin, synaptophysin and Pan-CK. A thorough work up of the patient to look for the site of primary malignancy was done and radiological findings reveled presence of an ill-defined soft tissue mass in the anal canal. Biopsy from the anal mass confirmed the diagnosis of anal melanoma with metastasis to breast. Conclusion The present case was reported to emphasize the importance of atypical presentation where the breast lump was the primary presentation of an anal melanoma. Therefore, we should have a strong index of suspicion for metastatic tumors in case of a breast lump especially when there is unusual morphology or unexpected immunophenotype, particularly if the neoplasm is triple-negative, in patients with a previous history of other malignancies.

Osseous metaplasia is a reversible condition in which non-osseous soft tissue is replaced by bone. This is most commonly seen in musculoskeletal system and central nervous system. Osseous metaplasia in breast is a rare event. In this case series, we have reported 4 cases of osseous metaplasia of breast. 1 case of Osseous metaplasia in benign phyllodes tumor, 1 case of Osseous metaplasia in fibroadenoma, 1 case of Osseous metaplasia in invasive breast carcinoma and 1 extremely rare case of Osseous metaplasia of breast presenting as breast lump without any other associated pathology. Since osseous metaplasia of breast is a rare phenomenon, this entity specially in association with benign breast disease conditions pose a great challenge for accurate diagnosis. [ABSTRACT FROM AUTHOR]

This article discusses the rare co-occurrence of granulomatous mastitis and collagenous spherulosis in a breast lump. The case study involves a 65-year-old female with a gradually progressive lump in her right breast. Fine needle aspiration cytology (FNAC) was performed, and the smears showed ill-formed granulomas, inflammatory cells, and homogeneous hyaline stromal globular elements. The diagnosis was a benign breast lesion: collagenous spherulosis with granulomatous mastitis. The article emphasizes the importance of recognizing the cytomorphological features to aid in the cytological diagnosis. [Extracted from the article]

Background. Benign breast diseases are a potential health concern to a large number of women. The incidence of cancer is increasing worldwide. A steady increase in incidence has been observed in most developed and developing counties. Objective. Thus, our study seeks to investigate the anthropometric variables implicated in breast lesions of women of reproductive age. Methods. This is a descriptive and prospective study with a random sampling method; the data was obtained from the Department of Surgery, Radiotherapy and Oncology Unit of University of Port Harcourt Teaching Hospital. A total number of 146 subjects (18-49 years) were involved into this study. A number of 90 were breast lump patients and 56 were breast cancer patients. Results. Data obtained was analysed with Microsoft Excel. Our results show no statistically significant difference (P> 0.05) in the body mass index (BMI) and waist-hip-ratio (WHR) of both the breast lump and breast cancer patients. This study supports the fact that high BMI is a predictive marker for breast lumps and cancer in women. Conclusion. The study has also identified that high BMI favours the incidence of breast lumps and breast cancers in women of reproductive age.

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory condition of the breast. IGM is a benign condition, and is more typical in women of child-bearing age, with a recent history of pregnancy and breast feeding. Its clinical presentation can mimic inflammatory breast cancer or breast abscess. The etiology of IGM is not well defined, but proposed to be a localized immune reaction to the breast tissue without the presence of an underlying infectious condition.Here we report a case of a healthy 35-year-old female, with no story of pregnancy and lactation, who presented with sudden left breast lump, swelling and pain. She underwent first diagnostic ultrasound of the affected breast, then breast MR imaging was performed. A biopsy of the lesion was obtained, which revealed chronic granulomatous inflammation, confirming the diagnosis of GM. Furthermore, the patient was found to have had hyperprolactinemia secondary to a prolactinoma of the pituitary gland (PitNET) many years before, during her 20s, for which she had been treated with surgery.

Background: Fine needle aspiration biopsy (FNAB), accompanied by classification systems for cytology, can offer a cheap and convenient option for the diagnosis of breast cancer in women with suspicious breast lumps. In this study, we aimed to assess the accuracy of the International Academy of Cytology (IAC) Yokohama system in a Vietnamese oncology centre. Methods: A retrospective cross‐sectional study was conducted from November 2021 to April 2022 at Vietnam National Cancer Hospital. We included patients with full hospital records regarding breast lesions for which FNAB was indicated. A total of 803 patients' FNAB specimens were assessed according to the IAC Yokohama system. The basic characteristics were summarised using the appropriate summary measurements. The risk of malignancy (ROM) was calculated for each classification category. Results: The median age was 42.7 years (range: 14‐85). The mean size of the lesions was 17.9 mm (range: 4‐123 mm). We had 215 histopathological reports. The most common benign and malignant diagnoses were fibroadenoma and invasive carcinoma, respectively. The ROM for categories II, III, IV, and V was calculated as 3.4%, 37.5%, 95%, and 99.2% respectively. The sensitivity, specificity, positive predictive value, and negative predictive value were 96.4%, 97.2%, 98.5%, and 93.2%, respectively. Conclusion: The IAC Yokohama system offers a good option with which to predict underlying breast pathology using a simple and cheap procedure. However, pathologists require continuous training to ensure accurate interpretation of the slides. [ABSTRACT FROM AUTHOR]

Fine needle aspiration cytology (FNAC) has been established as the most preferable first line investigation for palpable breast lumps. Incidence of both benign and malignant breast lesions has been increasing in India in the recent times. Various predisposing factors have been attributed for the rapid surge of breast lesions. Materials & Methods: This study was carried out in the Department of Pathology, in the newly established Government Medical College and Hospital, Rajamahendravaram, Andhra Pradesh. A Total of 57 female patients presenting with palpable breast lump were subjected to FNAC procedure after taking history and doing general and local examination. Smears were prepared, stained and cytological diagnosis was made and reporting done by IAC (International Academy of Cytology), categories C1 to C5. Results: Most of the female patients presenting with palpable breast lump were in the age group of 31-40 years. The most common lesion diagnosed was Fibroadenoma. Malignancies formed 19.29% of all cases. Most of the lesions (71.95%) were in C2 category of IAC. Conclusion: FNAC is a fast and easily available technique to diagnose and differentiate between various benign and malignant breast lesions. It also guides the clinician for proper preoperative evaluation of patients. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Breast abscess of long duration can be tubercular origin in both developing and developed countries despite its rarity. A 34‐year‐old lady presented with painful lump on her breast for 2 months, which was diagnosed with mammary tuberculosis on basis of aspiration cytology and successfully treated with antitubercular drugs. Breast abscess of long duration may be tubercular etiology in both developing and developed nations. [ABSTRACT FROM AUTHOR]

Background: For an accurate diagnosis of the breast lump FNAC (Fine Needle Aspiration Cytology) has gained wide popularity and acceptance as a quick, simple and reliable diagnostic procedure that can be carried as outpatient service.5 Present study was aimed to compare diagnostic accuracy of FNAC with histopathology in benign and malignant breast lumps. Material and Methods: Present study was comparative, observational study, conducted in female patients having unknown primary diagnosis of breast lumps and had undergone FNAC followed by excision biopsy/surgery. Results: In present study, 68 female patients having unknown primary diagnosis of breast lumps and had undergone FNAC followed by excision biopsy/surgery. Mean age was 49.5 ± 21.43 years & majority were from <30 years (32.35 %) & 30-39 years (19.12 %). Diagnosis by FNAC was of benign pathology in 46 cases (67.65 %) & malignant in 22 cases (32.35 %). Among benign cases majority were had fibroadenoma (42.65 %) followed by fibrocystic disease (11.76 %), benign cystic lesion (7.35 %) & benign cytological pattern (5.88 %). Among malignant cases majority were had atypical ductal hyperplasia (22.06 %) followed by intraductal carcinoma (5.88 %), ductal hyperplasia without atypia (2.94 %) & phyllodes tumour (1.47 %). When FNAC examination findings were compared with histopathological examinations findings (as standard), sensitivity was 95.45 %, specificity was 97.83 %, positive predictive value was 95.45 %, negative predictive value was 97.83 % & diagnostic accuracy was 94.5 %. Conclusion: Fine needle aspiration cytology is a comfortable, easy, reliable, rapid and simple diagnostic test with sensitivity, specificity, positive predictive value, negative predictive value & diagnostic accuracy of 95.45 %, 97.83 %, 95.45 %, 97.83 % & 94.5 % respectively compared to histopathology as standard. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of various categories of lesions in needle core biopsies done in breast lumps and the utility of using the reporting categories (B1 – B5) of the Royal College of Pathologists London (United Kingdom). Study Design: Cross-sectional study. Place and Duration of Study: Department of Histopathology, Foundation University Medical College, Islamabad Pakistan, from Jan to Dec 2021. Methodology: The study included one hundred cases of needle core biopsies done on breast lumps. After processing the tissue, the slides were made and stained with Hematoxylin and Eosin. Microscopic evaluation was done by the consultant Histopathologist. The frequency of various breast lesions was analyzed, and they were categorized into different ‘B’ categories according to Royal College of Pathologists guidelines. Results: The lesions included in B1 category (Normal tissue) comprised five cases (5%), B2 category (Benign) twenty cases (20%), B3 category (Uncertain malignant potential) twelve cases (12%), B4 category (Suspicious for malignancy) three cases (3%) and B5 category (Malignant) sixty cases (60%). Conclusion: Reporting of needle core biopsies, according to the reporting categories of the Royal College of Pathologists, London (B1–B5), gives a precise diagnosis of most lesions and provides the clinician with a clear road map for further management. B5 Category (Malignant) lesions are needle core biopsies' most common histological outcomes.

Introduction: Fine Needle Aspiration Cytology (FNAC) is a rapid, minimally invasive and cost-effective procedure with a high sensitivity rate of 92-95% and high Positive Predictive Value (PPV) approaching 100% for the diagnosis of breast malignancies. International Academy of Cytology (IAC) Yokohama system for reporting breast FNACs had been established in 2016 to bring consistency and uniformity of breast cytology reporting. Aim: To classify the breast lesions according to the IAC Yokohama system for cytological reporting of breast lesions. Materials and Methods: This was a retrospective six years study carried out in the Department of Pathology, Karpaga Vinayaga Institute of Medical Sciences, Chinnakolambakkam, Tamil Nadu, India. All females breast FNAC cases reported during the year January 2015 to December 2020 were included in the study according to the inclusion criteria. Relevant clinical and pathological data including the FNAC reports were retrieved from the medical records of the department. Corresponding FNAC smears stained with Haematoxylin and Eosin (H&E) and Papanicolaou stains were reviewed and double-checked with the FNAC reports. All those cases were grouped according to the IAC Yokohama System. Statistical analysis was carried out using Statistical Package for the Social Sciences (SPSS) version 23.0. Results: Of the total 381 female breast FNACs, majority (60%) of them belonged to the age group of 21-40 years. The predominant presenting symptom was palpable breast lump (73%) and Upper Outer Quadrant (UOQ) was involved in 65% of cases. Out of 381 cases, 297 (78%) were benign, 52 (13.6%) were malignant and 32 (8.4%) were inadequate for diagnosis. Total 73.8% cases belonged to “C2” category and fibroadenoma was the most prevalent lesion. Pearson Chi-square test showed highly significant association between patient’s age above 40 years and the risk of having a malignant breast lesion (p

The breast lump is the commonest presentation in clinically diagnosed breast cancer. There is a need to measure the diameter of the primary tumour accurately. In this review, we present the rationale for precise measurement of tumour size and its relationship with outcomes of therapy. [ABSTRACT FROM AUTHOR]

This case-control study, conducted at the Hospital USM BestARi unit, aimed to identify the serum metabolic fingerprint among individuals with breast lumps and healthy controls, and to discover potential biomarkers. Serum samples from healthy controls, benign breast lump patients, and malignant breast lump patients were analyzed using proton nuclear magnetic resonance spectroscopy (1H NMR). A multivariate data analysis approach was employed, with the OPLS-DA and clustered heat map techniques effectively differentiating between the three groups. The study revealed significant metabolite variations across the groups and proposed D-glucose, glycerol, and glycine as potential biomarkers for breast cancer diagnosis. Metabolic pathways such as alanine, aspartate, glutamate metabolism, and glycine, serine, and threonine metabolism were implicated. The metabolomics approach coupled with multivariate analysis successfully identified key metabolites leading to group separation and suggested altered metabolic pathways. However, further research and integration with other ‘omics’ technologies are necessary for clinical translation. [ABSTRACT FROM AUTHOR]

Introduction: Breast Self-examination (BSE) is the simplest and easiest way to look for abnormalities. It's an inexpensive and easy procedure that needs to be implemented from a young age. BSE will help in early diagnosis and treatment of benign and malignant tumours. Inadequate knowledge about BSE was seen usually in non affluent women. Though, affluent individuals have access to good and better healthcare, still there seems to be a lack. Aim: To understand the reasons and barriers among affluent women concerning BSE. Materials and Methods: This descriptive cross-sectional study was conducted in the field area of Ayaan Institute of Medical Sciences, Hyderabad, India, from March 2021 to February 2022. A total of 250 women were included in the study between the ages of 21-49 years. Data was collected using a predesigned pretested questionnaire to evaluate socio-demographic, reasons and barriers to BSE. Data were presented in numbers and percentages. Results: The mean age of the study population was 34.60±8.31 years. All 250 women were educated and with the majority being graduates (n=176, 70.4%), only 140 (56%) had a working occupation and the 205 (82%) were married. The feeling of mass in either of the breast (123, 49.2%), followed by family history of breast cancer (99, 39.6%) and breast pain (92, 36.8%) were the common reasons for performing SBE. The barriers to self-examination were majorly due to lack of knowledge (164, 65.6%), lack of breast complaints (164, 65.6%), absence of lump (130, 52%), followed by 115 (46%) who did not like to touch their breast. Forgetfulness was seen in 93 (37.2%) subjects. Conclusion: Poor awareness of the BSE practice exists even among affluent women. There is an urgent need for awareness about screening techniques, including BSE, in media and health facilities. [ABSTRACT FROM AUTHOR]

Previous studies have shown that FNAC and CNB play a significant role in the diagnosis of breast lumps. FNAC has been used for a long time for this purpose along with clinical examination and mammography. It is popular because of its accuracy, cost-effectiveness, and ease of use. CNB has recently gained popularity, especially in the evaluation of non-palpable breast lesions. It has the advantages of lower inadequacy rates, allowing of Ancillary methods, grading, and typing of cancer. However, it is more time-consuming and expensive. Aims and Objectives 1. To compare the results of FNAC and Core Needle Biopsy in breast lump. 2. To evaluate the diagnostic accuracy of FNAC and Core Needle Biopsy with reference to their sensitivity, specificity, positive predictive value, negative predictive value, and accuracy METHODS A single centered prospective study including 180 patients with palpable breast lumps admitted to the Department of General Surgery, M.K.C.G. Medical College & Hospital, Berhampur during the period from July 2019 to June 2021. All consecutive breast lump cases in female patients keeping in view of the inclusion and exclusion criteria were included in the study. Patients with relevant clinical history were examined serological and routine investigations done. After explaining, informed consent is taken followed by patient underwent FNAC followed by CNB. RESULTS FNAC detected 40.6% cases of IDC and 1.7% of lobular cancer, 2.2% of medullary cancer. CNB detected 58.9% IDC cases and 1.7% lobular cancer, 1.7% medullary cancer. So CNB has better results as compared to FNAC CONCLUSION It is concluded that, CNB is better than FNAC in evaluating breast lumps. [ABSTRACT FROM AUTHOR]

Tubular adenomas of the breast belong to the category of fibroepithelial tumours of the breast, and it is composed of compact bilayer tubules with a sparse intervening stroma. It is usually circumscribed (may be nodular) benign tumour of the breast.Tubular adenomas are very rare benign tumours of the breast which mimic the clinical and radiological presentation of fibroadenomas. It usually presents as, a well-circumscribed, palpable painless mass. Surgical excision of this tumour is the main stay treatment. This report documents, a rare presentation of tubular adenoma in a 17-year-old girl who presented with a swelling in the right breast with pain, nipple discharge and nipple inversion. Breast ultrasound revealed, a large well-circumscribed heteroechoic lesion (8.5*3.8cm) within the right breast, giving breast within breast appearance and reported as Breast Imaging Reporting and Diagnostic Scoring system BIRADS III. Patient was provisionally diagnosed as giant fibroadenoma and was planned for excisional biopsy. Histopathological examination confirmed it to be tubular adenoma. The patient had an excellent postoperative recovery.

A palpable breast lump is a common presentation of breast disease to a general practitioner. Fortunately, investigation of most of these lumps will lead to a benign diagnosis. It is essential to have a clear and systematic approach when investigating a palpable breast lump to avoid over investigation with the resultant increase in healthcare cost and anxiety. This article will discuss an approach to evaluating and diagnosing a palpable breast lump in the primary care setting. [ABSTRACT FROM AUTHOR]

Fibroadenoma is the most common cause of benign breast lumps and is typically seen in women under the age of 40 years. Fibroadenomas are classified as simple, complex, giant, myxoid or juvenile. They present as smooth, rubbery, mobile masses on palpation. Ultrasonographic and mammographic features typical of fibroadenomas include solid, round, well-circumscribed masses, with or without lobulated features. They are predominantly treated conservatively although clinical pathways recommend referral for triple assessment. Surgical intervention is indicated by the presence of one or more of the following features: the presence of symptoms, a diameter greater than 2 cm, rapid growth rate, complex features, disease recurrence or patient anxiety. [ABSTRACT FROM AUTHOR]

Breast mass is a common finding in patients presenting to primary care, women's health, or urgent care clinics. There are multiple etiologies that can cause a palpable breast mass both benign and malignant. PAs must know how to approach a patient with a palpable breast mass as well as what appropriate diagnostic evaluation is needed. [ABSTRACT FROM AUTHOR]

Lactating adenomas, though considered being benign, sometimes turn out to be malignant. We are hereby presenting two cases of lactating adenomas which turned out to be harboring infiltrating duct cell carcinoma (DCC). Two lactating women with mass in the breast were referred from surgery for fine-needle aspiration cytology and biopsy. On histopathology, it was found that both had infiltrating DCC (either as collision tumor or as a malignant transformation of lactating adenoma). These cases point toward some association between lactating adenoma and DCC, however, small it may be. Therefore, any mass lesion in the breast should be followed up under strict vigilance for an early diagnosis and management of this deadly disease. A large sample size and elaborate study are required to frame its prognostic relevance. Like estrogen receptor and progesterone receptor, prolactin and prolactin receptor expression can be exploited for developing newer receptor-targeted therapy. [ABSTRACT FROM AUTHOR]

Fibroadenomas in postmenopausal women are quite uncommon, and so are epidermal inclusion cysts in the breast. The coexistence of both is very rare, and very limited literature is available about this occurrence. We report a postmenopausal female patient with complaints of breast lump masquerading as malignancy on triple assessment which upon subsequent histopathological evaluation was confirmed to be fibroadenoma with intervening multiple epidermal inclusion cysts. In addition, the epidermal inclusions cysts were seen within the fibroadenoma without any association with the overlying skin and adnexa, adding to its rarity. So far, this is probably the fourth such case report to be documented in the literature with such coexistence and the first of its kind to be reported in a postmenopausal woman. [ABSTRACT FROM AUTHOR]

Extra medullary involvement of multiple myeloma is a known phenomenon, but breast and thyroid are rarely involved. This patient presented in onco-surgery OPD with breast lump and thyroid enlargement. The diagnosis of multiple myeloma involving both organs was made in a retrograde fashion. FNAC played a key role in diagnosing this lesion. A thorough clinical, radiological evaluation, strong suspicion and immunohistochemistry helped confirm the diagnosis of multiple myeloma.

Giant juvenile fibroadenomas, encountered usually in adolescents, are rapidly growing benign breast masses which lead to discomfort, anxiety and significant psychological stress. The breasts are in their early formative years, and thus, it is important to rule out malignancy as well as plan treatment options to preserve as much breast tissue as is possible. This report highlights a case of giant juvenile fibroadenoma diagnosed in a 12-year-old female child and our endeavour to achieve a good aesthetic result.

Background: Digital breast tomosynthesis (DBT) is a new imaging modality for improving breast cancer detection because it allowed for better detection of abnormalities, especially in females with dense breasts, and the diagnosis of benign lesions, which resulted in fewer recalled cases and negative biopsies, as well as assessing therapeutic efficacy. Objectives: Evaluation of the diagnostic validity of 3D wide-angle Digital Breast Tomosynthesis (WA-DBT) during screening programs for breast cancer (BC). Patients and Methods: 449 women with breast lesions who attended the screening campaign were examined by Full- field Digital Mammography (DMG) and WA-DBT using Hologic™ Selenia® Dimensions® 3D Performance System and ultrasound (US) imaging using GE LOGIQ P7® linear probe (7-12 MHz). Then, a surgical biopsy was obtained from women who had lesions of BI-RADS grade 4 or 5 and examined pathologically, the pathological diagnosis was used as the gold standard for comparison of radiological diagnoses. Results: Pathological diagnosis defined 30 malignant and 9 benign lesions. The performance characteristics of WA- DBT imaging were superior to that of DMG and US and the agreement of diagnoses obtained by WA-DBT and both DMG and US was moderate and substantial with κ coefficient of 0.421 and 0.726, respectively. ROC curve analysis defined WA-DBT as the best diagnostic test with a significantly higher area under the curve (AUC) in relation to the reference AUC as a discriminative diagnostic modality for breast lumps of BI-RADS grade 5 and as the most sensitive modality for differentiation between masses that are probably benign (BI-RADS grade 3) and that suspicious of malignancy (BI-RADS grade 4). Conclusion: WA-DBT is a valuable radiologic modality for screening women with breast lesions especially those in dense/extremely dense breasts. Also, WA-DBT can precisely identify microcalcifications obscuring very small-to- small breast lesions thus allowing early detection of BC. [ABSTRACT FROM AUTHOR]

Objective: The vast majority of breast cancers are diagnosed via image-guided procedures yet despite significant advances, imaging does not identify all breast malignancies. Clinically suspicious breast lesions with normal breast imaging remain a cause for concern. The aim of this study is to determine the diagnostic value of clinical core and cutaneous punch biopsies in the diagnosis of breast malignancy in clinically suspicious lesions with normal breast imaging. Methods: All patients with suspicious clinical breast findings and normal imaging who underwent a clinical core and/or cutaneous punch biopsy from 2012 to 2019 were reviewed retrospectively. Patients with subsequent breast malignant diagnosis were analysed. Results: A total of 283 biopsies (166 clinical core, 117 cutaneous punch) performed over the 7-year period were included in the analysis. A total of 263/283 (93%) yielded a benign outcome. A total of 2/283 (0.7%) yielded B3 lesions (probably benign). These lesions were benign on final surgical excision. A total of 18/283 (6.3%) yielded a malignant histopathology. Sixteen out of 18 were cutaneous punch biopsies, and 2/18 were clinical core biopsies. A total of 14/18 patients presented with nipple changes, while 4/18 had a palpable area of concern. Histopathological analysis demonstrated Paget's disease of the nipple in 8/18, invasive carcinoma in 9/18 out of which two represented a recurrence of breast malignancy. Cutaneous squamous cell carcinoma was diagnosed in 1/18. Conclusion: Clinical core and cutaneous punch biopsies remain a valuable tool in the diagnosis of breast cancer particularly in the management of clinically suspicious radiographically occult malignancies. [ABSTRACT FROM AUTHOR]

Purpose: The goals of this study were to report our clinical experience in a single center at a high-volume tertiary university hospital in Istanbul and to introduce a diagnostic algorithm based on a 5-year follow-up of 152 women with biopsy-proven idiopathic granulomatous mastitis (IGM). IGM is an uncommon, non-malignant, chronic inflammatory disease of the mammary gland with an unknown etiology. The symptoms, clinical presentation, and radiologic findings of IGM may resemble carcinomas. To our knowledge, this study comprises the largest series of IGM, especially with a 5-year follow-up, yet reported in the English literature. Methods: The present study reported our single-center clinical experience at a tertiary university hospital in Istanbul, Turkey, and introduced a diagnostic algorithm using our treatment protocol based on a 5-year follow-up of 152 women with biopsy-proven IGM. Our database of 10 years' experience containing over 700 patients with IGM was evaluated. However, to assess recurrence and resistance to treatment, only the 152 patients with a long follow-up period of 5 years were included in the study group. The analysis included 152 women with biopsy-proven IGM who were treated between January 2009 and March 2014. The clinical data of the presentation, histopathology, and treatment modalities were analyzed by reviewing the medical records. Results: Of the 152 patients diagnosed with granulomatous mastitis, 32 (21%) recovered by expectant management, while 14 (9%) responded to antibiotics, 65 (43%) received corticosteroids, 20 (13%) had antituberculosis medication, 16 (11%) underwent excision, and 5 (3%) responded to non-steroidal anti-inflammatory drugs. Fifty-one patients (33%) had recurrence; of these, 30 achieved a cure with second-line treatment, 16 underwent excision, and 5 achieved a cure with observation. Conclusion: IGM is a rare benign breast disorder, and clinicians need a high index of suspicion to diagnose it, as IGM can be mistaken for breast cancer. Unlike periductal mastitis, IGM does not evolve secondary to nicotine addiction and is typically seen in women of childbearing age with a recent history of pregnancy and lactation. The diagnosis can be challenging, and an evaluation with a multidisciplinary team is necessary. There is no consensus concerning the definitive treatment approach. We suggested a diagnostic algorithm in the present study, using our treatment protocol based on the 5 years' follow-up of 152 women. [ABSTRACT FROM AUTHOR]

Background: Breast masses have a variety of etiologies, benign and malignant. Fibroadenoma is the most common benign breast mass; invasive ductal carcinoma is the most common malignancy. Most masses are benign, but breast cancer is the most common cancer and the leading cause of cancer deaths in women. Although most breast cancers occur in women older than 50, a significant number of women are diagnosed with breast cancer younger than 50. An efficient and accurate evaluation can maximize cancer detection and minimize unnecessary testing and procedures. Objectives: Our study aimed to explore the frequency & pattern of different types of breast lumps in various age groups. Materials & method: This cross-sectional observational study was carried out in the inpatient and outpatient department of surgery at Shaheed Ziaur Rahman Medical College Hospital, Bogra, from July 2008 to Dec 2008. A total of 130 patients with palpable breast lumps were included in the study. The age of the patients was between 11 to 70 years. Fine Needle Aspiration Cytology and biopsy were done for most of the patients with a breast lump. Sometimes ultrasonography, mammography, and other routine investigations were also done. Result: In this study, the most common age was 11 to 20. The three most common diseases presented with lumps were Fibroadenoma, Carcinoma of the breast, and fibroadenosis. Peak age incidence of fibroadenoma was observed in the 11 to 20 age group (66%), while fibroadenosis was common in the third decade (46%), and peak age incidence was between the late twenties and early thirties. Carcinoma of the breast was common in 31 to 40 years age group (40%). No carcinoma was found below the age of 22 years. Most of the patients with carcinoma presented in an advanced stage. This reflects on illiteracy, poverty, lack of awareness, and medical facilities screening procedure in our population. Conclusion: The diversity of clinical presentation of breast lumps in different age groups was observed in our hospital practice, and a correlation between clinical manifestations, FNAC findings, and histological diagnosis of breast lumps was made. Fibroadenoma was common in the second and third decades, while breast carcinoma was common in third and fourth decades. Here we attempted to find out the age incidence of the breast lump and its correlation with clinical features, FNAC findings, and histopathological reports to improve the accuracy of diagnosis and management of breast disease. [ABSTRACT FROM AUTHOR]

Background: Carcinoma of breast is the most common non skin malignancy in women and is second only to lung cancer as a cause of cancer deaths1. FNA has now become a popular investigation to assess the nature of palpable breast lesions. The purpose of FNA is to confirm cancer preoperatively and to avoid unnecessary surgery in specific benign conditions2. Material And Methods: The observational study (prospective) was conducted in the cytology section in Department of Pathology over a period of 2 years (December 2018- November 2020) and included 100 patients who presented with palpable breast breast lumps. Cytomorphological features of all the lesions were studied. The findings were tabulated and analysed. Result: There were 98 female and 2 male patients. Majority of the patients were from the age group of 31 - 40 yrs. There was no significant association between the gender, duration of symptoms with the side of the breast involved. In benign breast lesions, fibroadenoma was most common and amongst malignant lesions, Ductal carcinoma. Conclusion: FNAC is a good diagnostic tool for breast lesions and it should be considered as a primary investigation of choice for suspected breast lesions considering its safety, simplicity and inexpensive characteristics. [ABSTRACT FROM AUTHOR]

Background Breast cancer is the most frequently diagnosed cancer in women worldwide, accounting for more than one in ten new cancer cases each year. It ranks as the second leading cause of cancer-related mortality among women. The majority of patients present with palpable breast lumps. Effective surgical management of breast cancer largely depends on accurate preoperative pathological diagnosis. This study evaluates the diagnostic accuracy and prognostic implications of fine-needle aspiration cytology (FNAC) compared with core needle biopsy (CNB) in breast carcinoma. Objectives The objectives of this study are to assess the sensitivity and specificity of FNAC and CNB, to compare the diagnostic accuracy of FNAC and CNB against histopathological findings from gross specimens in the evaluation of breast lumps, and to identify and examine the limitations associated with both FNAC and CNB procedures. Materials and methods This study included female patients presenting with clinically suspicious palpable breast lumps at the General Surgery OPD of Bankura Sammilani Medical College and Hospital, Bankura. All patients underwent FNAC followed by CNB. The cytological and CNB diagnoses were compared with the final pathological diagnosis obtained from excisional biopsy. Results The study included 44 female patients aged 20 to 70 years. The most common age group for breast carcinoma was 50-59 years (36.36%). Malignancy was diagnosed in 75% of cases (33/44), with right breast involvement (65%) being more common than the left. The upper outer quadrant (59%) was the most frequently affected area. Among the 33 confirmed malignant cases, 69.70% had lesions larger than 5 cm. FNAC demonstrated a sensitivity of 93.93%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 84.61%, and diagnostic accuracy of 95.45%. CNB showed a sensitivity of 96.97%, specificity of 100%, PPV of 100%, NPV of 91.67%, and diagnostic accuracy of 97.73%. Both methods correlated significantly with the final histopathology results (p < 0.05). FNAC identified ductal carcinoma in 93.55% of cases, while CNB identified it in 96.77%. Conclusion CNB provides additional information on receptor status but is more resource-intensive. FNAC remains a cost-effective and time-efficient first-line diagnostic tool, especially in resource-constrained settings like rural India. FNAC should be employed for initial diagnosis, with CNB reserved for cases requiring further clarification., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee of Bankura Sammilani Medical College issued approval 185. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Pradhan et al.)

The majority of breast malignancies are either ductal or lobular tumors. A rare benign neoplasm of adnexal origin, cylindroma of the breast, was first described 23 years ago, and 21 cases have been documented in the literature since then. We report a case of a breast cylindroma on a 62-year-old woman who presented with a nodule first detected by a national mammographic screening program. We review the radiological and histological characteristics, diagnosis, and clinical course of this entity and discuss the previous cases in the literature. In addition, we emphasize on the challenges of differential diagnosis of this rare form of breast tumor from the solid variant of adenoid cystic carcinomas and the management of similar conditions., Competing Interests: Human subjects: All authors have confirmed that this study did not involve human participants or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Papaoikonomou et al.)