Mastalgia and associated breast diseases in a tertiary care center, Tamil Nadu: A cross-sectional study

Background: Mastalgia is the common breast condition among women. Mastalgia has highly variable prevalence which ranges 41–79%. It is more common in age group between 30 and 50 years. Mastalgia is approached according to its classification into three major categories, that is, cyclical pain, non-cyclical pain, and extra mammary pain. Breast pain ranges from mild to severe influencing the lifestyle of women affecting sexual relations, sleep pattern, and decreasing their daily life activities. Aim and Objectives: The aim of the study was to determine the incidence of benign and malignant breast disease in mastalgia. Materials and Methods: This cross-sectional study was conducted in Government Medical College, Sivagangai. Patients complaining of breast pain were examined. The data were compiled in an Excel worksheet, Epiinfo version 7.0 was used to analyze the data. Results: In our study, 100 patients complaining of breast pain were examined ranging from age 18 to 68 years. The mean age of the study population was 37.54 years and standard deviation of 9.077. Among 100 patients with mastalgia only 1 (1.64%) had malignancy which is insignificant and among rest 99 patients with mastalgia, 60.61% had benign breast diseases and 39.39% had no any breast lesions. Benign breast diseases are more commonly found in patients with mastalgia. Conclusion: Women having mastalgia can be reassured and some lifestyle modifications may aid the women. Hence, early detection of any breast disease in women having mastalgia and treating accordingly has considerable importance. Lifestyle modifications are needed in patients with mastalgia and they should come to facility to check and identify the issues and solve soon.

Study of spectrum and clinical profile of benign breast disease in the rural area: is there any change

Background: Recent understanding of pathophysiology and health awareness may have impact on spectrum of benign breast disease (BBD) in rural area. We have analyzed clinical data of 88 cases of BBD for spectrum and clinical profile to compare with present studies.Methods: Clinical records of 88 cases of BBD were reviewed for demographic details, clinical presentation, management and outcome. Recent literature related to BBD in rural area was searched using various search engines. Results of our study were compared with recent studies.Results: Fibroadenoma (FA) was most common condition followed by fibrocystic disease. BBD were common in third decade 46 (52.3%). Lump was present in 87 cases. Lump was painful in 45 (52.3%), and associated with fever in 15 (17.1%) cases. Fine needle aspiration cytology and ultrasound was done in 70 and 32 patients in which diagnostic accuracy with histopathology was seen in 69.7% and 56.2% respectively. Surgical treatment included lumpectomy, lump excision, mastectomy, drainage with debridement and axillary clearance. Three patients of breast tuberculosis were treated with 9 months AKT. When compared with recent studies, over all spectrum was same expect chronic abscess presenting as lump was more in our series.Conclusions: Our study revealed benign neoplasms, inflammatory condition and tumor like lesions in 43.1%, 14.6% and 13.8% cases respectively. FA was the most common lesion. BBD were common in third decade. Except the chronic mastitis, incidence of various types of benign lesions was comparable with those found in other studies. There is not much change in overall spectrum of benign breast disease.

Role of ormeloxifene in regression of benign breast diseases

Background: Benign breast diseases are common pathological entities with which women in her early reproductive age present to OPD with fear of malignancy and significant morbidity. Except for surgery and use of non-selective estrogen receptor blockers, there are no other treatment options, and these have lot side effects. Ormeloxifene a newer drug has shown promising results with minimal side effects and used as the first line of treatment reducing the morbidity of surgery and subjecting the patient to less hormonal side effects.Methods: Diagnosis of benign breast diseases was made by baseline investigation which included measurement of size of fibroadenoma using Vernier caliper and USG, fibroadenosis,ie nodularity measured using  Lucknow-Cardiff scale and VAS score was used for pain assessment of mastalgia after which patients will be given the drug and  placebo and the response for the drug and its side effects are noted.Results: 61.9% (44) were diagnosed with fibroadenoma, 16.9% (12) with fibroadenosis and 21.1% (15) with mastalgia. Lucknow Cardiff score for fibroadenosis exhibited 50% had smooth breasts with no nodularity at the end of six months, in fibroadenoma group 52% showed decrease in size and 31% showed complete disappearance of the lump and in the mastalgia group 40% had no pain (VAS score of 0). 16(22.5%) of had menstrual abnormality as the major side effect.Conclusions: Ormeloxifene can be used as the first line of treatment in patients with fibroadenosis and mastalgia and used as an alternative to surgery for fibroadenoma.

A clinico-pathological study of benign breast diseases in rural population.

Background: Objective of current study was to study the pattern of benign breast diseases in females in our society. Methods: One hundred females who were treated in the department of surgery at Agartala government medical college & G B P Hospital, Agartala, Tripura (West) with various forms of benign breast diseases during the period from January 2013 to December 2013, were studied. Diagnosis were made by a combination of clinical assessment, radiological imaging and tissue biopsy so - called triple assessment. Results: The commonest presentation of benign breast diseases was breast lump followed by nodularity of breast. Fibroadnomas are the commonest benign breast disease and fibrocystic changes form the second most common lesion. The common age group of benign breast diseases range from 21 years to 40 years. This might be associated with certain environmental, regional, dietary or hormonal factors. Conclusion: The result of this study showed that benign breast diseases in females of our society are fibroadenomas followed by fibrocystic diseases. The actual factors responsible for this change needs further research and study.

Surgery for benign breast diseases through areolar incision / 中华内分泌外科杂志

Objective To explore the indications, superiority and surgical technique of periareolar approach in the management of benign breast diseases. Methods 132 patients with benign breast disease (91 cases of Fibroadenoma, 12 cases of limited gland hyperplasia, 8 cases of cyst, 2 cases of benign phyllodes tumor and 6 cases of male gynecomastia) underwent operation through areolar incision. Results All patients were followed up for 1-10 months. 107 cases were satisfied with their treatment,19 cases were not quite satisfied with the relatively long incision, and 6 cases were not satisfied with the front incision. The one-month-later reexamination showed that 117 cases feel good and 15 cases had partial numbness of the nipple (15/132, 11.36%). All but two patients wound healing delayed because of local hematoma (2/132, 1.52%). Neither necrosis nor infection was found. Conclusions With the advantages of fewer complications and cosmetic effect, periareolar approach can be applied in management of various benign breast diseases. Factors such as indications, anatomical layer, postoperative molding, appropriate drainage, pressure dressing should be taken into consideration for the success of operation.

A Study for The Relationship between Steroid Receptor Expression and Histologic Findings in Breast Diseases / 한국유방암학회지

The role of steroid receptor has been widely studied and well established in the field of breast cancer. In contrast of breast cancer, the clinicopathological roles of steroid receptors in benign breast diseases were not established clearly until now. Authors evaluated steroid receptor expressions of benign breast diseases using the immuno-histochemical staining and analyzed their relationship with pathologic types and the correlation between the positivity of steroid receptor expression and the proliferative activity of ductal epithelial cells. The results were follows; 1) The assayed tissue specimens were 93 cases which consisted with fibrocystic disease, 39 cases and fibroadenoma, 54 cases. 2) The positivity rate of steroid receptor expression in fibroadenoma (ER: 59.2%, PR: 75.9%) seemed to be more higher than in fibrecystic diseases (ER: 46.1%, PR: 55.5%) without a statistical significance. 3) The positivity rate of ER expression of fibrocystic diseases developed in premenopausal women (54.8%) was significantly higher than in postmenopausal women (2.5%). 4) Any significant correlation was not noted between the positivity of steroid receptor expression in the tissue and ductal epithelial proliferative activity. In conclusion, fibrocystic disease and fibroadenomas possessed a significant amount of steroid receptor positive cells in their tissues. However, the positivity of steroid receptor expression in the tissues seemed to have few correlation with the ductal epithelial cellular proliferation.