Spectrum of Breast Diseases: Histopathological and Immunohistochemical Study from North India.

INTRODUCTION: Breast disorders commonly present as masses, which are mostly benign. However, breast cancer is the most common form of cancer and second leading cause of death among women. The study aimed at analyzing the spectrum of breast diseases especially breast cancers and assess the estrogen and progesterone receptor (ER/PR) and Her2/neu status of breast cancers on immunohistochemistry (IHC). MATERIALS AND METHODS: This was a descriptive study of 2 years (Jan 2014 - Dec 2015). All specimens of primary breast diseases received during this period at the Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, UP, India, were analyzed. RESULTS: A total of 148 breast specimens from 10 males and 133 females, (age range, 15 - 75 years; mean age, 36 years) were selected. Majority of patients presented in 4th (29.7%) and 3rd (27.7%) decades with breast lumps (97.3%), affecting mostly right breast (52%). Benign diseases (60.1%) were the commonest followed by malignant (28.4%) and inflammatory lesions (11.5%). Fibroadenoma (52.6%) and fibrocystic change (21.8%) were the commonest benign diseases and granulomatous mastitis (23.5%), the commonest inflammatory lesion. Malignancy contributed 30.6% of female breast lesions (age range, 25-75 years and mean age, 48.2 years) with 97.6% of cases being infiltrating ductal carcinomas. ER expression was seen in 58%, PR in 54.8% and Her2/neu positivity in 45.2% cases. In males, gynecomastia was the most common breast lesion (90.9%). CONCLUSION: Breast diseases affected mostly young people with fibroadenoma and infiltrating ductal carcinoma being the commonest diseases. Malignant breast diseases affected females only. ER/PR hormone receptor expressions are lower compared to western countries.

Utility of FineNeedle Aspiration Cytology as a Lowcost Tool to Diagnose Cervical Lymphadenopathy.

BACKGROUND AND OBJECTIVE: The current study aimed at observing the cytomorpho logical patterns in patients presenting with enlarged cervical lymphnodes, diagnosed by fine needle aspiration cytology (FNAC), their distribution with respect to age and gender, and determining the accuracy of FNAC as a diagnostic procedure in cases with cervical lymphadenopathy. METHODS: Out of all patients presenting with cervical lymphadenopathy from Sep tember 2015 to September 2016, in the Department of Pathology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India 100 consecutive cases were enrolled into the current study, following the exclusion of all cases where FNAC smears were inadequate or suboptimal for diagnostic interpretation. Histopath ological examination was conducted on small excision biopsy specimens/radical neck dissection, where ever possible and diagnostic efficacy of FNAC was evaluated. RESULTS: The overall age range of the enrolled patients, presenting with enlarged cervical lymph nodes, was 172 years with the mean age of 35.7 years and male femaleratio of 1.6:1.Out of the 100 cases, benign and malignant lesions comprised 77 and 23 cases, respectively. The most common observed benign lesion was reactive hyperplasia (29%), while squamous cell carcinoma was the most common malignant lesion.The overall sensitivity, specificity, positive predictive value, negative predic tive value, and the diagnostic accuracy was 100%, 91.67%, 92%, 100%, and 95.7%, respectively. CONCLUSION: FNAC in the diagnoses of inflammatory and neoplastic diseases serves as a reliable,lowcost, rapid diagnostic tool with reasonably good accuracy that can influence patient management in terms of early diagnoses, treatment, and prevention of unnecessary surgery in patients.