Breast lumps are one of the most common clinical presentations encountered in surgical practice and represent a wide spectrum of pathological conditions ranging from benign lesions to malignancies [1]. The presence of a breast lump often causes significant anxiety among patients, making accurate diagnosis essential for appropriate management. Breast cancer is the most common malignancy among women in India and a leading cause of cancer-related mortality, largely due to delayed diagnosis and presentation [2]. However, the majority of breast lumps are benign, particularly in younger women, with fibroadenoma being the most frequently encountered lesion [3]. Differentiating benign from malignant breast lesions is therefore crucial to avoid unnecessary surgical interventions and psychological distress. The breast undergoes continuous physiological and hormonal changes throughout a woman’s life, predisposing it to various benign and malignant disorders [4]. Clinically, breast lumps may present with pain, nipple discharge, skin changes, or axillary lymphadenopathy, although many lesions remain asymptomatic [5]. The evaluation of breast lumps relies on a multidisciplinary “triple assessment” approach comprising clinical examination, imaging, and pathological evaluation [6]. Fine Needle Aspiration Cytology (FNAC) and histopathological examination play a pivotal role in establishing the diagnosis, guiding surgical management, and confirming the nature of the lesion, with histopathology being the gold standard [7]. Several clinicopathological studies conducted in tertiary care hospitals have demonstrated that benign breast lesions predominate in younger age groups, while malignant lesions are more common in older women [8,9]. Despite this, regional variations exist in the pattern and presentation of breast lumps. Hence, the present study was undertaken to evaluate the clinicopathological correlation of breast lumps in patients attending a tertiary care hospital, with the aim of improving diagnostic accuracy and strengthening the integrated role of surgical and pathological assessment in breast disease management.

Study Design and Setting This was a hospital-based observational study conducted in the Department of General Surgery in collaboration with the Department of Pathology at a tertiary care hospital of Gujarat. Study Duration The study was carried out over a period of 12 months from June 2024 to May 2025. Study Population All patients presenting with palpable breast lumps to the surgical outpatient department or admitted to surgical wards during the study period were included. Inclusion Criteria • Patients of either sex presenting with a clinically palpable breast lump • Patients willing to give informed written consent Exclusion Criteria • Patients previously diagnosed or treated for breast malignancy • Recurrent breast lumps • Patients unwilling to participate in the study Sample Size A total of 170 patients fulfilling the inclusion criteria were enrolled in the study. Study Procedure After obtaining informed consent, detailed clinical history was recorded including age, duration of symptoms, pain, nipple discharge, and family history. A thorough clinical breast examination was performed noting the site, size, consistency, mobility of the lump, skin changes, nipple retraction, and axillary lymph node status. All patients underwent Fine Needle Aspiration Cytology (FNAC). Patients who underwent surgical excision had the specimens sent for histopathological examination, which was considered the final diagnostic modality. FNAC findings were correlated with histopathological results wherever available. Data Analysis Data were compiled using Microsoft Excel and analyzed using descriptive statistics. Results were expressed as frequencies, percentages, mean, and standard deviation. Clinicopathological correlation was assessed using appropriate statistical methods. The study was approved by the Institutional Ethics Committee. Written informed consent was obtained from all participants, and confidentiality of patient data was strictly maintained.

A total of 170 patients presenting with breast lumps were included in the study. The clinicopathological findings were analyzed and are presented below. Table 1. Age Distribution of Study Participants (n = 170) Age group (years) Number of patients Percentage (%) 18-20 22 12.9 21–30 58 34.1 31–40 42 24.7 41–50 28 16.5 >50 20 11.8 Total 170 100 The majority of patients were in the 21–30 years age group (34.1%), followed by the 31–40 years age group (24.7%). Breast lumps were less common in patients above 50 years of age. Table 2. Clinical Presentation of Breast Lumps Clinical feature Number (n) Percentage (%) Painless lump 98 57.6 Painful lump 46 27.1 Lump with nipple discharge 14 8.2 Lump with skin changes 12 7.1 The most common presenting complaint was a painless breast lump (57.6%), followed by painful lumps (27.1%). Nipple discharge and skin changes were less frequently observed. Table 3. Site of Breast Lump Location of lump Number (n) Percentage (%) Upper outer quadrant 74 43.5 Upper inner quadrant 36 21.2 Lower outer quadrant 28 16.5 Lower inner quadrant 18 10.6 Central 14 8.2 The upper outer quadrant was the most commonly involved site (43.5%), followed by the upper inner quadrant (21.2%). Table 4. FNAC Diagnosis of Breast Lumps FNAC diagnosis Number (n) Percentage (%) Fibroadenoma 78 45.9 Fibrocystic disease 32 18.8 Inflammatory lesions 20 11.8 Suspicious for malignancy 18 10.6 Malignant 22 12.9 Total 170 100 FNAC revealed that benign lesions predominated, with fibroadenoma being the most common diagnosis (45.9%). Malignant lesions were identified in 12.9% of cases. Table 5. Histopathological Diagnosis of Operated Cases (n = 170) Histopathological diagnosis Number (n) Percentage (%) Fibroadenoma 74 43.5 Fibrocystic disease 30 17.6 Inflammatory lesions 18 10.6 Carcinoma breast 28 16.5 Other benign lesions 20 11.8 Histopathological examination confirmed that fibroadenoma (43.5%) was the most common benign lesion. Carcinoma breast constituted 16.5% of cases, confirming malignancy predominantly in older age groups. Table 6. Clinicopathological Correlation FNAC diagnosis Histopathology concordant (n) Concordance (%) Benign 114 94.2 Malignant 26 92.8 A high degree of clinicopathological correlation was observed. FNAC showed excellent concordance with histopathological findings, particularly for benign lesions.

Breast lumps constitute one of the most common reasons for surgical consultation and represent a wide pathological spectrum ranging from benign to malignant lesions [1]. The present study evaluated the clinicopathological profile of breast lumps in 170 patients attending a tertiary care hospital and demonstrated that benign lesions were significantly more common than malignant ones. In the present study, the majority of patients belonged to the 21–30 years age group, which is in agreement with previous Indian studies reporting a higher prevalence of breast lumps among women in their reproductive years [1,4]. Similar age distributions have been observed by Datta et al. and Riaz et al., who reported that benign breast lesions predominate in the second and third decades of life [1,4]. This trend may be attributed to increased hormonal activity during the reproductive period, predisposing the breast to benign proliferative changes. A painless breast lump was the most common presenting complaint in the present study, followed by painful lumps. This finding is consistent with observations reported by Pandy et al. and Sothu et al., who also documented painless breast lump as the most frequent clinical presentation [5,7]. Associated symptoms such as nipple discharge and skin changes were less common and were more often linked to inflammatory or malignant pathology. The upper outer quadrant was the most frequently involved site in the present study. This observation is in concordance with findings reported in earlier studies, which have attributed this predominance to the greater amount of glandular tissue present in this quadrant [4,6]. Similar anatomical distribution has been documented by Riaz et al. and Singh et al. [4,6]. Fine Needle Aspiration Cytology (FNAC) findings in the present study revealed that fibroadenoma was the most common diagnosis, followed by fibrocystic disease and inflammatory lesions. These findings are consistent with multiple clinicopathological studies conducted in tertiary care centers, where fibroadenoma has been reported as the most common benign breast lesion, particularly in younger women [3,6,8]. The hormonal responsiveness of fibroadenoma likely explains its higher incidence in this age group. Histopathological examination, regarded as the gold standard for diagnosis, confirmed the predominance of benign breast lesions in the present study, with fibroadenoma being the most common histopathological finding. Carcinoma of the breast constituted a smaller but clinically significant proportion of cases, predominantly affecting older age groups. Similar distributions have been reported in previous studies, reinforcing the importance of histopathological evaluation for definitive diagnosis [2,8]. A high degree of clinicopathological concordance was observed between FNAC and histopathological findings in the present study. This supports the role of FNAC as a reliable, minimally invasive, and cost-effective diagnostic tool for the initial assessment of breast lumps. Comparable diagnostic accuracy of FNAC has been reported in earlier studies, highlighting its usefulness in guiding surgical management and reducing unnecessary interventions in benign cases [1,6]. Overall, the findings of the present study reaffirm that most breast lumps are benign, particularly in younger women, while malignancy is more commonly encountered in older age groups. The study emphasizes the importance of an integrated clinicopathological approach in the evaluation of breast lumps to ensure accurate diagnosis and appropriate management.

Breast lumps are commonly encountered in clinical practice, with benign lesions predominating, especially in younger women. Fibroadenoma was the most frequent diagnosis, while malignant lesions were more common in older age groups. FNAC showed good concordance with histopathology, confirming its usefulness as an initial diagnostic tool. A systematic clinicopathological approach is essential for accurate diagnosis and appropriate management of breast lumps.

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