Breast lesions are heterogeneous diseases that consist of several distinct entities with remarkably different characteristic features. Most of the breast lesions are well understood and well diagnosed while some of the unusual lesions and malignancies are less appreciated. Majority of the breast lesions initially present with a lump in the breast which is very sensitive for female patients due to which they might not report timely to the doctor for an examination.1

A timely and accurate diagnosis of a breast lump is crucial and early intervention alleviates anxiety and can be lifesaving. In recent years, breast lesions have gained increased importanceand global attention due to the increased mortality and morbidity associated with breast cancer and more awareness is being spread among women regarding breast lumps.1

Recognition of different neoplastic and nonneoplastic breast lesions is important for the differential diagnosis from malignant lesions and ultimately for the management of the patients with breast disease. The causes of breast masses are fibrocystic changes, fibroadenomas, breast infection, galactocele, and breast cancer. Malignant lesions account for 10% of the breast masses.2

Histopathology plays an important role in the diagnosis of breast lesions. It is the main criteria that assess the adequacy of treatment and is a necessary component in the diagnosis, treatment, and prognosis of breast diseases.3

The present study was a prospective study of 120 cases undertaken at the department of pathology in our institute for duration of 8 months ie from July 2024 to Feb 2025.

Inclusion criteria

Age distribution 18-60 years, Specimens from excisional biopsy, incisional biopsy, and trucut biopsy

Exclusion criteria

Age distribution less than 18-60 years, Women who have been treated for breast malignancy, Male breast lumps

Methodology 

 The specimens were received in different forms such as excisional biopsy, modified radical mastectomy , simple mastectomy, Lumpectomy The clinical details  was obtained from the biopsy requisition forms  Detailed gross examination was done and the specimens were fixed in 10% formalin followed by thorough sampling. For malignant tumors, the deeper surface was inked for examination of deep surgical margin. After fixation, representative tissue bits were taken from tumor proper, nipple and areola, deep surgical margin, adjacent breast and lymph nodes if available. The tissue bits were processed to make paraffin blocks. The sections were cut at 3-4 micron thickness and were stained with Hematoxylin and Eosin. Microscopic examination was done.

Age distribution :In the present study  age distribution varied from18- 60 years with majority among 41 – 50  years -46%(56/120), followed by 31 – 40  years -28.3%(34/120),51 – 60  years -14.1%(17/120),21 – 30  years -8.3%(10/120) and  18 – 20  years -2.5%(3/120)

Gender distribution: Majority were females accounting 100 %( 120/120)

Distribution of clinical features :Majority presented with Lump in breast -100% ,Pain in breast  3.3% (4/120), traction of nipple 15%(18/120), Nipple discharge16.6%(20/120)

Distribution of duration of clinical Symptoms: Majority presented with symptoms of >6 months20.8 % (25/120). Followed by 5-6months25) (30/120), 3-4months (20%) (24/120), 4-5months (16.6%) (20/120), month 0.91 %( 11/120). 2-3 months8.3 %( 10/120)

Distribution of location   of breast Lump: Right breast accounted 37.5 % (45/120), \ and left breast 62.5% (75/120).

Distribution of consistency of breast lump: Firm and Mobile in 8.3 % 70/120), Firm to hard and fixed15 %( 18/120), Hard and Fixed in 26.6 %( 32/120)

Distribution of quadrant of breast lump:

Upper and outer uadrant29.1 %( 35/120), Upper and inner quadrant16.6 %( 20/120)

Central quadrant3.33% (4/120), Lower and outer quadrant29.1%(35/120)Lower and inner quadrant11.6%(14/120),Retroareolar1.66%(2/120),Multifocal8.3%(10/120)

Distribution of   HPE diagnosis: Benign (73.3%) (88/120), Malignant (26.6%) (32/120)

Table 1: Distribution of lesions of breast on histopathology

DISCUSSION

Comparative studies related to age distribution

In the present study  age distribution varied from18- 60 years with majority among 41 – 50  years -46%(56/120), followed by 31 – 40  years -28.3%(34/120),51 – 60  years -14.1%(17/120),21 – 30  years -8.3%(10/120) and  18 – 20  years -2.5%(3/120).In Yogalaxmi et al⁴ the peak age of the occurrence of breast masses was in the 3rd decade (32% occurrence) followed by the 4th decade (26%  .About 17 patients were aged <20 years and 13 patients were aged >50 years. In Imam et al ⁵ study most cases (n = 93/255; 36.5%) were in the 30-39 years category. In Mrudula et al⁶ the peak age of occurrence of Benign cases was found between 21 and 30 years age group, that is, 63%, youngest case detected as fibroadenoma at 14 years of age. Malignant breast disease was found to be between 41 and 60 years, accounting for 73.6%,

Comparative studies related to sex distribution

 In our study majority were females accounting 100 % (120/120), In Imam et al⁵ study among 255 cases, 239 (93.7%) were female, while only 16 (6.3%) were males.

Comparative studies related to distribution of clinical Symptom

In our study Majority presented with Lump in breast -100% ,Pain in breast  3.3% (4/120), traction of nipple 15%(18/120), Nipple discharge16.6% (20/120), Similar findings  noted  in Yogalaxmi et al ⁴ study  .

Comparative studies related to distribution of Side of breast lump

In our study majority noted in Left  breast 62.5%.In Letha padmom et al ⁷most of cases presented with unilateral breast lump.

Comparative studies related to distribution of Quadrant

In our study the  breast lesions were most frequently located in upper outer quadrant   29.1%(35/120),followed by Lower and outer quadrant29.1%(35/120)similar findings noted in Sulhyan et al⁸  study .

Comparative studies related to distribution of benign and malignant lesions on

Histopathology

In our study Benign were 73.3 %( 88/120), Malignant 26.6 % (32/120), In Sulhyan et al⁷ study total 76 benign tumors. Total 53 malignant tumors were observed. Imam et al study5 most of the cases were benign (n = 150/255; 58.8%), followed by inflammatory lesions (n = 55/255; 21.6%), and the rest was malignant (n = 50/255; 19.6%).

   Table 1: Distribution of lesions of benign lesions of breast on histopathology

In the present study Fibroadenoma was most commonly reported similar finding were noted in Yoga laxmi et al^4, Yoga laxmi et al⁴ and Letha padmom⁷ et al study

 Table 4: Distribution of lesions of malignant lesions of breast on histopathology

In the present study Invasive ductal Carcinoma was most commonly reported similar finding were noted in Yoga laxmi et al^4, Mrudlual et al ^9, Sulhyan et al ⁸ and Letha padmom⁷ et al study.

We have studied a total of 120 cases of breast lesions histopathologically, in which benign breast lesions are more in number than malignant breast lesions. The benign tumors were most frequent in second, third decades, malignant tumors were mostly seen beyond 4th decade. Fibro adenoma was the most common benign tumor followed by Adenosis. . Invasive carcinoma - No special type was the most common malignant tumor.  Hence, histopathological study of breast lesions plays a very important role in diagnosis, treatment, and prognosis of breast lesions.

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