Histopathological Types of Benign Proliferative Lesions in Peritumoural Vicinity of Carcinoma Breast

Abstract

Introduction: The majority (90%) of lesions that occur in the breast are benign. In India, although benign breast diseases had a high incidence they have always been overshadowed clinically by breast cancer. Retrospective and prospective studies have shown relative risk of breast cancer of 1.5 to 1.6 for women with benign breast disease as compared with women in the general population. The presence of different lesions within the same breast adjacent to malignancy is also a phenomenon that can prove the multistep progression to malignancy. Aim: To determine the presence of any change in peritumoural area of carcinoma breast and to compare the pathological findings of tumour and adjacent area for co-existing benign proliferative lesions. Materials and Methods: The prospective, cross-sectional and observational study included 75 cases of mastectomy specimens of carcinoma breast conducted in the histopathology section of Department of Pathology, Jawaharlal Nehru Medical College (JNMC) in Sawangi (M) Wardha, from 1st August 2017 to 31st July 2019. The cases in which the histopathological diagnosis of infiltrating ductal carcinoma-not otherwise specified were made on Haematoxylin and Eosin (H&E) staining. Sections of the tumour and peritumoural area were studied in detail for co-existing lesions. Based on the predominant epithelial benign lesion present in peritumoural area, the lesions were classified morphologically as: Non-proliferative, Proliferative disease without atypia and Proliferative disease with atypia. Statistical analysis was done using descriptive and inferential statistics with the chi-square test and software used in the analysis were SPSS 24.0 version and GraphPad Prism 7.0 version. Results: Out of 75 cases diagnosed as carcinoma breast on H&E further peritumoural area was subcategorised as 29 cases of fibrocystic changes (38.67%), 8 cases of proliferative disease without atypia (10.66%) and 33 cases of proliferative disease with atypia (44%) associated with tumour. Conclusion: The study concludes that the most predominant histological lesions in peritumoural area of carcinoma breast are proliferative changes with atypia followed by fibrocystic changes which has an absolute lifetime risk of 13-17% transforming into carcinoma breast making these patients mandatory for followup and further management.

Keywords

• enign breast disease
• breast cancer
• fibrocystic
• peritumoural area